Thoracic Epidural Anesthesia and Analgesia For Gastric Resection at 26 Week Pregnant Woman
Esra Çalışkan1, Mesut Şener1, Tarık Zafer Nursal2, Kenan Çalışkan2, Ayda Türköz1, Tayfun Bağış3
1Baskent University, Faculty of Medicine,Department of Anesthesiology, Adana Teaching and Medical Research Center, Adana
2Baskent University, Faculty of Medicine,Department of General Surgery, Adana Teaching and Medical Research Center, Adana
3Baskent University, Faculty of Medicine,Department of Obstetrics and Gynaecology, Adana Teaching and Medical Research Center, Adana
Keywords: Pregnancy, gastric adenocarcinoma, surgery, thoracic epidural anesthesia, anaesthetic management, fetal stress
Abstract
Anesthesia and surgery are required in up to 1.5% to 2% of all pregnancies. Alterations in maternal anatomy and physiology create potential risks for both mother and fetus. The anesthetic considerations for any surgery during pregnancy must take both patients into account. Gastric adenocarcinoma presenting during pregnancy is a rare conditions and has a poor prognosis. This report describes anaesthetic management the case of a woman who was diagnosed with gastric adenocarcinoma at 26 weeks’ gestation. Distal subtotal gastrectomy was planned in an attempt to maximize the mother’s life expectancy while maintaining the pregnancy until the fetus reached viable gestation. A combination of general anesthesia and thoracic epidural anesthesia was used. The goal was to reduce physiological stress and minimize anesthesia risk for both mother and fetus and also diminish the neuroendocrine response during surgery. The patient was discharged from hospital 10 days after surgery and was then readmitted at 30 weeks’ gestation for an elective cesarean section.