You are to give anesthesia to a 65-year-old woman for laparoscopic low anterior colon resection. She has recently been diagnosed with colorectal carcinoma. The patient has been a heavy smoker in the past and has severe chronic obstructive pulmonary disease (COPD), with secondary moderate pulmonary hypertension. She also has essential hypertension. Medications include a beta-blocker, ACE inhibitor, inhaled steroid/beta-agonist and aspirin.

What are your concerns with this patients Hx?

What are the concerns with this surgery?

How would you handle the anesthetic?