Dobutamine infusion for complex congenital heart disease with pulmonary hypertension in an infant posted for open pyloromyotomy

Infantile hypertrophic pyloric stenosis (IHPS) is one of the most common gastrointestinal medical emergencies that occur during the first 2 months of life. Anaesthetic considerations in management of IHPS includes, aspiration prophylaxis and correction of metabolic derangements. An associated complex congenital cardiac lesion along with pulmonary hypertension and airway difficulties poses a further great challenge for the anaesthesiologist. We report a case of perioperative anesthetic management of a 2 month infant posted for open pyloromyotomy having complex congenital heart disease with pulmonary hypertension and bilateral cleft lip, the use of dobutamine in this setting is highlighted.