Bilateral superficial cervical plexus block for parathyroidectomy during pregnancy: A case report
Jun-Young Chung1, Yo Seob Lee1, Seung Yeon Pyeon2
1Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, South Korea.
World Journal of Clinical Cases
|June 6, 2022
Summary
Superficial cervical plexus block (SCPB) is a safe anesthetic option for pregnant women undergoing parathyroidectomy in early pregnancy. This approach successfully treated primary hyperparathyroidism (PHPT) without adverse maternal or fetal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Anesthesiology
Background:
- Primary hyperparathyroidism (PHPT) is a leading cause of hypercalcemia during pregnancy, posing risks to both mother and fetus.
- General anesthesia in pregnant patients carries maternal risks and potential long-term neurocognitive concerns for neonates.
- Surgical intervention for PHPT in pregnancy is often recommended, but the optimal timing and anesthetic approach remain debated due to miscarriage risks.
Observation:
- A pregnant patient at 11 weeks gestation with elevated serum calcium (12.9 mg/dL) and parathyroid hormone (157 pg/mL) underwent parathyroidectomy.
- A parathyroid adenoma was identified via ultrasound.
- Superficial cervical plexus block (SCPB) was utilized for anesthesia during the parathyroidectomy procedure.
Findings:
- The patient's calcium levels normalized within one week post-surgery.
- The fetus showed no signs of distress following the procedure.
- A healthy male neonate was delivered at 38 weeks gestation.
Implications:
- Superficial cervical plexus block (SCPB) presents a viable anesthetic alternative for parathyroidectomy in the first trimester of pregnancy.
- This case supports the safety and efficacy of SCPB in managing PHPT during pregnancy, mitigating risks associated with general anesthesia.
- Early surgical management of PHPT in pregnancy, facilitated by regional anesthesia techniques like SCPB, can lead to favorable maternal and neonatal outcomes.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...