Anesthesia Management of HoLEP in Patient of Multiple Myeloma with Permanent Pacemaker In Situ

The patient was advised on fasting guidelines for surgery as per the American Society of Anesthesiologists (ASA) standards.On the day of surgery, the patient was shifted to the operation room, and standard ASA monitors (ECG, pulse oximeter, and noninvasive blood pressure monitor) were attached.A 20-gauge intravenous cannula was secured in the right upper limb, and ringer lactate was administered at rate of 1 mL/kg/hour.Pacemaker-trained tech was called during the procedure for programming pacemaker machine.Patient's baseline mode was DDDR with heart rate of 60/minute.This was converted to VOO mode with heart rate set to 85/minute during perioperative period.