Surgery during pregnancy
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.
Review
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.
Sources
P., ŠTOURAČ, BLÁHA J., NOSKOVÁ P. et al. Selected aspects of anaesthesia for non-obstetric surgical procedures in the pregnant patient. Anesteziologie a intenzivní medicína [online]. 2016, 27(5), 294-301 [cit. 2019-10-10]. ISSN 1214-2158. Available at: https://www.prolekare.cz/casopisy/anesteziologie-intenzivni-medicina/2016-5/vybrane-aspekty-anestezie-u-operacnich-vykonu-z-neporodnicke-indikace-v-tehotenstvi-59643?fbclid=IwAR2vQSq74-HFDTIVy5R1l9Eru9lP7TmN7LfP55OFfVed40oyBcwZkeE_q4M
SEIDLOVÁ, D., P. ŠTOURAČ a et al. Specifika perioperační optimalizace rizikových částí populace. SEIDLOVÁ, D., P. ŠTOURAČ et al. Perioperační medicína nejen pro praktické lékaře. 2nd ed. Praha: Mladá fronta, 2018, s. 140-165. ISBN 978-80-204-4857-6.
