Background: In patients undergoing pneumonectomy, intraoperative pulmonary and cardiac complications are the major cause of morbidity and mortality. Protective lung ventilation strategies may decrease the overall lung injury. Right, ventricular dysfunction may occur during the surgery and after the pneumonectomy, in the early postoperative period, with reduced RV ejection fraction and increased RV end-diastolic volume index, caused by increased RV afterload. Case report: We describe the case of a 28-year-old non-smoker female who underwent to a right pneumonectomy. The patient presented intraoperative hemodynamic instability and signs of RV dysfunction, requiring vasoactive amines and nitric oxide. Discussion: This article is intended to provide an overview of the anesthetic management for pneumonectomy including the hemodynamic management and considerations of the causes and management of right ventricular dysfunction.

Introduction: Perioperative anaphylaxis is a rare but serious, life-threatening condition that presents challenges in diagnosis and management. The incidence of severe perioperative reactions is estimated to be approximately 1:7,000–10,000. Case report: A 75-year-old patient underwent a surgical procedure due to adhesions of previous surgeries. She had a serious anaphylactic reaction in the intraoperative period, which was quickly addressed with fluid and adrenaline administration. Discussion: Proper management involves both immediate stabilization of the patient and identification of the causing agent. This identification is essential to avoid the recurrence of the event in other surgeries. A previous history of perioperative hypersensitivity reaction is the main risk factor for anaphylaxis.

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Jehovah’s witness refusion to blood products is based on the interpretation of the bible as blood transfusion carries itself potential risks and is a special issue in this group of patients this report suggest that blood transfusion should be guided by personal triggers, based on hemodynamic and laboratory indices associated with age and comorbidities.