[Anesthetic management of a patient with esophageal hiatal hernia accompanied with chest pain].

We experienced the perioperative management of the esophageal hiatus hernia (sliding type). As the patient had had severe and frequent chest pain attacks and abnormal ECG, it was essential to evaluate the degree of cardiac and pulmonary functions. To prevent aspiration pneumonia, the patient had been placed on intravenous hyperalimentation and H2-blocker, and tracheal intubation was performed by rapid anesthetic induction technic without using awake or crash intubation methods. The intraoperative course was uneventful and the chest pain diminished immediately after the operation. In summary, the key points were as follows; (1) accurate evaluation of cardiac and pulmonary functions, and (2) prophylaxis for aspiration pneumonia at the time of anesthetic induction.