Anaesthesia for laparoscopic cholecystectomy in a patient with Eisenmenger's syndrome

We describe the management of a patient with Eisenmenger's syndromepresenting for laparoscopic cholecystectomy. Of prime concern wasmaintenance of systemic vascular resistance and this was achieved usinginfusion of noradrenaline started before induction of anaesthesia andcontinued after operation. Avoidance of other factors that couldpotentially increase right to left shunt flow contributed to the successfuloutcome.