Pseudomyxoma peritoni is treatable with newer surgical modalities like cytoreductive surgery and hyperthermic 
intraperitoneal chemotherapy (HIPEC), and the anesthetic management can be challenging. In our case, the 
perioperative management was further complicated by the presence of Sjogren’s syndrome which has its own 
anesthetic implications. This may be the first reported case of anesthetic management of HIPEC in a patient having 
Sjogren’s syndrome along with its perioperative considerations include fluid management, stable hemodynamics, 
thermoregulation, electrolyte balance, intraoperative massive fluid shifts, ventilatory management, avoidance of 
renal toxicity and suppression of cytokines release plays a major role in the management in this patient.