Anaesthetic Management in Successive Spinal Surgeries During Pregnancy and Postpartum

Abstract

In this case report, we present a parturient with spinal tumour who required neurosurgery before and after caesarean delivery under general anaesthesia. A 25-year-old woman at 30 weeks of gestation and suffering from bilateral lower-limb weakness and sensory deficit due to spinal tumour underwent emergent laminectomy and decompression surgery under general anaesthesia. In this case, total intravenous anaesthesia was used. Two weeks later, the patient underwent emergent caesarean delivery under general anaesthesia due to preterm labour and gave birth to a healthy new-born. Meanwhile, pathological exam revealed soft tissue sarcoma requiring re-operation for gross total excision in the postpartum Week 4, which was followed by multisession chemoradiotherapy. The patient survived for 3 years, that is, until generalised systemic and neural metastasis. General anaesthesia management in surgeries before and after caesarean delivery in patients with spinal tumours is of utmost importance in providing optimal maternal, foetal and neonatal safety using a multidisciplinary team approach.

Keywords: General anaesthesia; neurosurgery; postpartum; pregnancy; spinal tumour.