Surgery during pregnancy

Author: Assoc. Prof. Petr Štourač MD PhD, Esther Cheng MD, Lucia Šmahovská, Jakub Švec

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: pregnancy | appendicitis | crush induction | intrauterine resuscitation | analgesia in pregnant

Educational evel: Undergraduate level | Graduate

The management of anesthesia for non-obstetric surgery during pregnancy is not so common. However, this kind of an intervention includes some specifics that a capable anesthesiologist should know and also the risks he should have in mind and know how to prevent them or how to deal with them. This algorithm is supposed to show you how to proceed in this situation. It includes choice of anesthesia, anesthesia management, post-operative care, as well as right diagnosis and surgery indications. It marginally touches any complications associated with this intervention.

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Anaesthesia during pregnancy is not very common, so it is very good to recall and practice the procedure. It is always an acute event, such as trauma or acute abdomen. Elective surgery is not routinely performed during pregnancy.
This algorithm shows how to proceed correctly from receiving care of a patient with an acute abdomen, not to underestimate serious symptoms and whether to decide for surgery despite ongoing pregnancy. It is important how to perform an induction to anaesthesia, anaesthesia management, how to deal with possible complications and the right choice for sufficient postoperative analgesia. All these procedures - crush introduction, preoxygenation, general anaesthesia always with intubation, sufficient analgesia and others are well shown in the algorithm.
I wish to all the least frequent anesthesias during pregnancy, however there is no need to worry if the right course is followed. And as we see on this nicely created algorithm, anesthesia can be safe for both mother and fetus.

publikováno: 21. 5. 2019 | last modified on: 19. 12. 2019