Anesthesia for emergency cesarean section for the pregnant patient with surgically corrected scoliosis is associated with potential risks for both mother and the fetus due to alterations in maternal physiology and the pathological changes seen in scoliosis. The anesthetic management must address the well being of both mother and fetus. The need for anesthesia for obstetric delivery in pregnant women with scoliosis is much more than in the normal parturient. We report the successful use of spinal anesthesia in a patient with surgically corrected scoliosis for emergency cesarean section.

Anaesthetic management of patients with hepatic dysfunction can be quite challenging, as many anaesthetic agents are metabolized by liver. Heart disease on anti coagulation can pose additional challenge. Here we report a case of Gilbert's syndrome with rheumatic heart disease on anti coagulation posted for elective hernia repair.

Broncho-esophageal fistula (BEF) are quite rare in adults, more so the congenital variety. The common causes of BEF in adults include infections, trauma, and malignancies. We report a rare case of congenital BEF manifesting in adulthood with repeated pulmonary infections. We emphasize mainly on the preoperative preparation and perioperative management of this patient. It is essential to have a high index of suspicion to diagnose congenital BEF in adults. Anesthesiologists play an important role in successful management of these cases.

Interference of monitored electrocardiogram (ECG) is a common event in intensive care units and operation theaters. Artifacts in the ECG tracing can resemble serious arrhythmia, thus leading to unnecessary usage of antiarrhythmics or electrical defibrillation. In addition, ECG artifacts may lead to serious hemodynamic consequences secondary to intra-aortic balloon pump (IABP) trigger failure. We report a rare event of IABP failure due to ECG artifact, which appeared on placement of the transthoracic echocardiography probe over the chest. Subsequent evaluation revealed potential current leakage from echocardiography machine secondary to earthing defect in the machine.

Cholecystectomy represents the second most common surgery during pregnancy. Both general and regional anesthetic techniques have been successfully used for cholecystectomy in pregnant patients. Authors present here a case of a pregnant patient carrying twin gestation who underwent cholecystectomy, which is not frequently encountered by the anesthesiologists. This report enumerates the perioperative issues relating to anesthesia given to a pregnant patient in addition to emphasizing the importance of multidisciplinary approach when such a case is encountered.