ABSTRACT A 58 year old female patient weighing 76 kgs is posted for gangrenous excision of right great toe. She is a k/c/o- CAD, HTN, DM-II and hypothyroidism on treatment. Patient has been stabilized preoperatively and all the lab values were within the normal range. Being a short surgical procedure we gave an ankle block because of the underlying co-morbid conditions. After surgical procedure, which hardly took 30 mins, patient developed acute LVF. Immediately resuscitated, treated and stabilized in the OT for 2 hours with intubation, positive pressure ventilation+ PEEP on an anaesthetic ventilator, propped up position, diuretics, opioids and ionotropes. Subsequently, case managed in ICU with morphine, diuretics, insulin infusion, meticulous monitoring and overnight ventilation. Extubation done next day afternoon. Observed for 48 hours and referred to cardiologist for evaluation. Case preoperative assessment, risk factors, intraoperative development of events, management in the OT as well as ICU will be discussed.

METHODS : A case management

RESULTS : successful management of the case in OT and ICU.

CONCLUSIONS : successful management of Acute LVF