Noonan syndrome is a condition involving facial, cardiovascular and skeletal abnormalities that may pose problems to anesthesiologists during surgery. Propofol, which is used as an induction agent for noncardiac surgery, produces little or no change in the heart rate. Remifentanil decreases the sympathetic and somatic responses to noxious stimuli and can be given in high doses without negative inotropic effects. We report successful management of a patient with Noonan syndrome, hypertrophic cardiomyopathy, and atrial fibrillation, undergoing laparoscopic cholecystectomy using the the total intravenous anesthesia with propofol and remifentanil.
Anesthesia, Intravenous* ; Atrial Fibrillation ; Cardiomyopathy, Hypertrophic ; Cholecystectomy, Laparoscopic ; Heart Rate ; Humans ; Noonan Syndrome* ; Propofol

Human immunodeficiency virus (HIV), when infected causes various systemic changes and is the cause of the fatal disease called acquired immune deficiency syndrome (AIDS). With the sharp increase of infection in women, pregnancy can be complicated by HIV infection. Although there have been astonishing developments in therapy there are still many risks in the pregnant HIV patients. The anesthetic management will depend on the patients clinical status, current treatment as well as the well-being of the fetus. We report a case of spinal anesthesia in a 36-year-old pregnant HIV patient undergoing cesarean section.
Acquired Immunodeficiency Syndrome ; Adult ; Anesthesia, Spinal ; Cesarean Section* ; Female ; Fetus ; HIV Infections ; HIV* ; Humans ; Pregnancy