An extremely low birth weight (832 g) and 29 gestational week neonate underwent surgical ligation of patent ductus arterious 20 days after birth and repair of coarctation of the aorta two months after the first operation. She developed asphyxia neonatorum and was artificially ventilated because of IRDS and attack of apnea. At the first operation, anesthesia was maintained with fentanyl and sevoflurane. The only perioperative complication was severe hypothermia (34.5 degrees C). At the second operation, anesthesia maintenance was identical to the first operation. The only perioperative complication was mild hyperthermia (37.7 degrees C). The key points of anesthetic management were the use of a low inspired oxygen fraction to avoid retrolental fibroplasia at a gestational age before 32 weeks and management of the baby's temperature.