Goal oriented general anesthesia for Cesarean section in a parturient with a large intracranial epidermoid cyst

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
C ImarengiayeJ Kingdom

Abstract

To illustrate the anesthetic management of a term parturient with a large brain tumour scheduled for Cesarean section. A 26-yr-old woman presented at 33 weeks gestation with a generalized grand mal seizure. Magnetic resonance imaging demonstrated a 5-cm multi-lobulated extra axial mass compatible with an epidermoid cyst, arising from the left temporal lobe associated with shift of the midline structures and compression of the brainstem. She remained stable neurologically until elective Cesarean section at 38 weeks. Immediately prior to induction of general anesthesia, the proposed incision site was infiltrated with lidocaine and the supraglottic structures anesthetized with bilateral superior laryngeal nerve blocks. Remifentanil, thiopentone sodium and succinylcholine were administered in a rapid sequence fashion following voluntary hyperventilation to an endtidal CO2 of 28 mmHg. Anesthesia was maintained with desflurane in oxygen/air and an infusion of remifentanil. Postoperative pain control was achieved using a multi-modal approach which included intraperitoneal deposition of local anesthetic, im ketorolac and rectal acetaminophen prior to emergence followed by regular administration of naproxen and acetaminophen for 72 hr. ...Continue Reading

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Citations

Aug 5, 2008·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Sudha Indu SinghWjotech Dobkowski
May 26, 2009·International Journal of Obstetric Anesthesia·U FreoC Ori
Mar 6, 2008·Anesthesiology Clinics·David Hill
Apr 3, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·L BouattourA Karoui
Mar 9, 2005·Acta Anaesthesiologica Scandinavica·F RichaM C Antakly
Nov 11, 2008·International Journal of Obstetric Anesthesia·J L H FrenchN M Bedforth
Mar 11, 2016·Current Opinion in Anaesthesiology·Marc Van de Velde

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