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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
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Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension

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Anesthetic management of a pregnant patient undergoing open splenectomy for hypersplenism

Malavika Kulkarni1, Laxmi Shenoy1, M S Sagar1

  • 1Department of Anesthesia, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

Anesthesia, Essays and Researches
|April 18, 2015
PubMed

An estimated 0.75-2% of pregnant women undergo nonobstetric surgery during pregnancy. Surgery is indicated during pregnancy only if it is absolutely essential for wellbeing of mother and fetus. A 25-year-old primigravida with 22 weeks gestation diagnosed with extra hepatic portal venous obstruction, hypersplenism, and refractory pancytopenia was posted for open splenectomy. General anesthesia was administered by rapid sequence induction and endotracheal intubation. The perioperative management involved ensuring hemodynamic stability with administration of blood and blood products for around 2.5 L blood loss. The procedure was completed in 4 h. Patient was extubated with an uneventful postoperative course. A fetal ultrasound showed no variation from preprocedure baseline. Optimal anesthetic management requires an understanding into normal alterations in maternal physiology during pregnancy and potential fetal effects from anesthesia and surgery.

Keywords:
Anesthesianonobstetric surgerypregnancy

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