Anaesthetic Management in Successive Spinal Surgeries During Pregnancy and Postpartum

Area of Science:

• Neurosurgery
• Obstetrics
• Anesthesiology

Background:

• A 25-year-old pregnant patient at 30 weeks gestation presented with bilateral lower-limb weakness and sensory deficit.
• The symptoms were attributed to a spinal tumor, necessitating urgent surgical intervention.

Observation:

• The patient underwent emergent laminectomy and decompression surgery under general anesthesia with total intravenous anesthesia.
• Two weeks postpartum, she delivered a healthy infant via emergent cesarean delivery under general anesthesia.
• Postpartum diagnosis of soft tissue sarcoma led to a second surgery for complete excision, followed by chemoradiotherapy.

Findings:

• The patient survived for 3 years before succumbing to generalized systemic and neural metastasis.
• Successful management involved a multidisciplinary team approach.

Implications:

• This case highlights the critical importance of meticulous general anesthesia management in pregnant patients with spinal tumors undergoing multiple surgical procedures.
• Emphasizes the need for a coordinated multidisciplinary team to ensure optimal outcomes for mother, fetus, and neonate.