Thoracic epidural anaesthesia is one of the safe and good alternative to general anaesthesia in high risk patients of chronic obstructive pulmonary disease and asthma where general anaesthesia is contraindicated. A 55 years old female patient was scheduled for modified radical mastectomy on account of advanced carcinoma of right breast. The patient was known case of bronchial asthma since 5 years with frequent attacks per week for which she was taking nebulisation with salbutamol and budesonide two times per day. In the pre-operative evaluation, her vitals were within normal limit but on auscultation air entry was reduced all over the chest with bilateral crepts and rhochi present. We did this patient in plaine thoracic epidural anaesthesia without haemodynamic instability. Thoracic epidural anaesthesia and analgesia for mastectomy is feasible, and it offers additional benefits in high-risk patients.

Background: Total Anomalous Pulmonary Venous Connection (TAPVC) is congenital heart disease in which the pulmonary veins do not connect normally to left atrium. Instead they connect to right atrium, often by way of systemic vein. There may be associated cardiac malposition. Anaesthetic management requires detailed assessment of cardiac an extracardiac anomalies & its pathophysiological effects.Here we report a case of TAPVC posted for LSCS and its successful management. Case Presentation: 25yrs female known case of TAPVC at 34.5 wks of gestation admitted 3 weeks prior, Vitaly stable, we did this patient under plain epidural anaesthesia without haemodynamic instability. Conclusions: Epidural anaesthesia a better technique than general anaesthesia for supracardiac TAPVC posted for LSCS. Meticulous intraoperative monitoring is important. Cardiac Output must be maintained, avoid fall in Systemic Vascular Resistance (SVR) ensuring minimal change in shunt.

BACKGROUND: Patients with paradoxical ventricular septal motion are a challenge to anaesthesiologist due to risk of perioperative myocardial ischaemia and sudden cardiac arrest. CASE DESCRIPTION: We present anaesthetic management of a 45year old lady with a diagnosed case of carcinoma left buccal mucosa with paradoxical ventricular septal motion posted for modified radical neck dissection with radial free flap. CONCLUSION: Although clinical manifestations of this cardiac condition may be mild, there is certainly associated pathology of direct relevance, which carries importance in the anaesthetic management in the peri-operative period. Patients with paradoxical ventricular septal motion of any etiology are more prone for perioperative myocardial ischaemia and sudden cardiac arrest, because if cardiac conduction is not maintained properly then it may result in further increase in the paradoxical ventricular septal motion.