Anaesthetic management of advanced liver disease patient for major head neck oncology surgery: a case report

Patients with chronic liver disease pose a serious challenge to anaesthesiologists because of multisystem involvement; despite advances in perioperative management, this subset of patients is at high risk for perioperative hepatic decompensation, encephalopathy, and mortality. In this case report we are describing anaesthetic management of a male patient known case of carcinoma buccal mucosa with maxillary recurrence and chronic liver disease with model for end stage liver disease score of 10 posted for major head neck surgery, we did multidisciplinary team discussion to decide plan for perioperative management of this patient having direct coombs test positive and with apt biochemical testing along with thromboelastography (TEG) guided swift correction with blood and blood products lead to favourable outcome in our patient.