Nikhil Mudgalkar^a, Shrikant Panachal^b, Jogenpalli Ashwin^c

^aAssociate Professor, Department of Anesthesia, ^bAssistant Professor, Department of Anesthesia, Prathima Institute of Medical Sciences, Karimnagar , Andhra Pradesh, India.

Address for correspondenceDr. Nikhil Mudgalkar, Associate Professor, Department of Anesthesia, Prathima Institute of Medical Sciences, Karimnagar, Andhra Pradesh, India.

Email: drniks2000@yahoo.com

Introduction: Patients with Cor pulmonale pose a difficult challenge for the anesthesiologist.

Case report:We present a case of 75 year old female with cor pulmonale with fracture left femur posted for Austin Moore prosthesis. Regional anesthesia with invasive haemodynamic measurement was done with successful perioperative management.

Discussion: proper understanding of pathophysiology,preoperative optimization of the patient, invasive cardiovascular monitoring and avoidance of factors raising pulmonary artery pressure are keys of successful management .

Conclusion: In a subset of patients who do not have left ventricular dysfunction secondary to cor pulmonale, regional anesthesia is an option but should be guided by invasive haemodynamic data.

Key words: : Cor pulmonale, fracture neck femur, regional anesthesia