Management of a premature infant with PDA poses a significant challenge in the perioperative period for the anaesthesiologist. The risk is multiplied when it is associated with other congenital respiratory anomalies. In our case a premature child at 5 month of age presented with PDA and tracheomalacia. There was a risk of airway collapse during sedation or induction of anaesthesia along with an anticipated difficult intubation. We have managed the case by inducing and intubating the patient in

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... he lateral position without using muscle relaxants. We have used Sevoflurane as the sole anaesthetic agent for inducing and intubating the patient. Postoperatively patient was extubated in lateral position and succesfully discharged from ICU.