To the Editor: Anesthesia has established a remarkable safety record. Vigilance in the preoperative, intraoperative, and postoperative periods is needed to ensure this safety [1]. We recently encountered a case that reiterates the importance of a careful preoperative assessment. A 47-year-old woman presented to a district hospital in South India with low back pain and menstrual irregularities. She was diagnosed with fibroids, and underwent hyster