Perioperative anaesthetic management of pediatric hepatoblastoma for hepatic resection

16 month old child was brought to the hospital with loose motions, vomiting and a history of failure to gain weight. Examination revealed hepatomegaly. Investigations revealed a space occupying lesion in the right lobe of the liver. She was diagnosed as a case of hepatoblastoma and was given 7 cycles of chemotherapy following which she was taken up for Right hepatectomy. Hepatic malignancies being rare in this age group and the surgery planned being extensive, the anaesthetic management was challenging. The child was taken up as a high risk case and successfully managed with the use of balanced anaesthesia in conjunction with epidural analgesia and invasive pressure monitoring.