One lung, two coronary stents and three centimeters malignan
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When patient-related concerns are multiple, the anaesthetic considerations also multiply. Stereotactic neurosurgery is done for diagnostic and/or therapeutic purposes for selective brain lesions and may require prolonged general anaesthesia. It involves three-dimensional localization of lesions (for biopsy/treatment) utilizing a specialized stereotactic localization head frame system. Airway management (both mask ventilation and endotracheal intubation) becomes difficult with the frame in situ. We hereby present a known hypertensive patient with raised intracranial tension for stereotactic neurosurgery. Our patient also had two coronary artery stents, following previous myocardial ischemia. A major anaesthetic challenge was posed by the presence only one lung in this patient, following a left-sided pneumonectomy done for bronchogenic carcinoma. This case report highlights the successful anaesthetic management of such a complex case with judicious ventilatory and hemodynamic optimization...

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