title: Thoracic epidural anesthesia and analgesia for gastric resection at 26 week pregnant woman.
abstract: Anesthesia and surgery are required in up to 1.5% to 2% of all pregnancies. Alterations in maternal anatomy and physiology create potential risks for both mother and fetus. The anesthetic considerations for any surgery during pregnancy must take both patients into account. Gastric adenocarcinoma presenting during pregnancy is a rare condition and has a poor prognosis. This report describes anaesthetic management of a woman who was diagnosed with gastric adenocarcinoma at 26 weeks' gestation. Distal subtotal gastrectomy was planned in an attempt to maximize the mother's life expectancy while maintaining the pregnancy until the fetus reached viable gestation. A combination of general anesthesia and thoracic epidural anesthesia was used. The goal was to reduce physiological stress and minimize anesthesia risk for both mother and fetus and also diminish the neuroendocrine response during the surgery. The patient was discharged from the hospital 10 days after the surgery and was then readmitted at 30 weeks' gestation for an elective cesarean section.
authors.affiliation: Baskent University, Faculty of Medicine, Adana Teaching and Medical Research Center, Department of Anesthesiology, Adana, Turkey. esra_ertr@yahoo.com
authors.forename: Esra
authors.initials: E
authors.lastname: Calişkan
authors.forename: Mesut
authors.initials: M
authors.lastname: Sener
authors.forename: Tarik Zafer
authors.initials: TZ
authors.lastname: Nursal
authors.forename: Kenan
authors.initials: K
authors.lastname: Calişkan
authors.forename: Ayda
authors.initials: A
authors.lastname: Türköz
authors.forename: Tayfun
authors.initials: T
authors.lastname: Bağiş
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000230:Adenocarcinoma / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods; D000768:Anesthesia, General / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007231:Infant, Newborn; D009325:Nausea / Q000209:etiology; D010149:Postoperative Pain / Q000517:prevention & control*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D011262:Pregnancy Trimester, Second; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014839:Vomiting / Q000209:etiology