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Anaesthesia management of patient with cardiac comorbidities underwent non -cardiac surgery has always been challenging. The goal of anaesthesia management is to keep the myocardial oxygen supply greater than the demand to avoid ischemia . In this case, anaesthesia implications included preoperatively assessing the cardiovascular and respiratory status with selecting ultrasound guided epidural anaesthesia and analgesia techniques . Incremental doses of local anaesthetic were given to maintain myocardial oxygen demand .Here, a 70-year-old female with a history of self fall was diagnosed with a right tibia fracture and known case of ischemic heart disease with kyphotic spine successfully underwent tibia nailing under ultrasound guided epidural anaesthesia.
AjithKumar et al. (Mon,) studied this question.