ABSTRACT : To present a case report of an old lady with coronary artery disease, parkinsonism and atrial fibrillation undergoing successful laparoscopic cholecystectomy under general anaesthesia.

OBJECTIVE: To present a case report of an old lady with hypertension, coronary artery disease, parkinsonism and atrial fibrillation undergoing successful laparoscopic cholecystectomy surgery under general anaesthesia.

Methods: A 75 year old lady came to our hospital with complains of stomach pain. She was diagnosed to have calculous cholecystitis. It was planned to do a laparoscopic cholecystectomy for her. During pre anaesthetic check she was found to be in atrial fibrillation. She had a history of Parkinsonism, hypertension and ischemic heart disease. Her echocardiogram showed evidence of aortic sclerosis, LV diastolic dysfunction. ECG showed atrial fibrillation.

RESULTS: An uneventful general anaesthesia was given for her and the surgery was done successfully. She was extubated on table. Her post op period was uneventful and was discharged after few days.

DISCUSSION: Atrial Fibrillation is one of the commonest arrhythmia found intra op. The pneumoperitoneum, reverse trendelenberg position along with positive pressure ventilation, all contribute to problems in a cardiac patient. Pneumoperitoneum, itself can precipitate atrial fibrillation, especially in presence of ischemic heart disease.

CONCLUSION: A geriatric female patient with multiple problems, including atrial fibrillation was successfully given general anaesthesia for undergoing laparoscopic cholecystectomy