Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 8 2 2022 03 12 159 161 Jyoti Deshpande Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. Merlin Jacob Department of Anaesthesiology, Smt. Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India. 2021 08 17 2021 08 31 Choosing appropriate anesthetic modality in patients with compromised cardiac function with the administration of peripheral nerve block ensures hemodynamic stability. We present the case of a 63y, male patient with an operative history of aortic valvuloplasty, on anticoagulant warfarin. Patient was given general anesthesia and supraglottic airway device, LMA was inserted to prevent intubation response. This was supplemented with USG guided ilioinguinal and iliohypogastric nerve blocks with inj ropivacaine 0.325%, 15ml and inj dexamethasone 2mg as adjuvant. Addition of peripheral nerve blockade to general anesthesia provided perioperative analgesia, so quick emergence and recovery was possible. https://aacc.tums.ac.ir/index.php/aacc/article/view/393