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

We describe the management of a patient with Eisenmenger's syndrome presenting for laparoscopic cholecystectomy. Of prime concern was maintenance of systemic vascular resistance and this was achieved using infusion of noradrenaline started before induction of anaesthesia and continued after operation. Avoidance of other factors that could potentially increase right to left shunt flow contributed to the successful outcome.