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NEUROSURGICAL ANESTHESIOLOGY

Neuroanesthesia for the Pregnant Woman

Lars Peter Wang, MD (Cph), FANZCA^*, and Michael James Paech, MBBS, DRCOG, FRCA, FANZCA, FFPMANZCA, FRANZCOG (Hon), DM

From the *Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, and Pharmacology and Anaesthesiology Unit, School of Medicine and Pharmacology, University of Western Australia, Perth, Washington.

Address correspondence and reprint requests to Dr. Lars P. Wang, Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia. Address e-mail to lars.wang{at}health.wa.gov.au or lpwang{at}iinet.net.au.

Abstract

Neuroanesthesia for the pregnant patient is required infrequently, and evidence-based recommendations for neuroanesthetic management are sparse. We present a framework for a practical approach to anesthesia of the pregnant patient with subarachnoid or intracerebral hemorrhage, intracranial tumor, traumatic brain injury, spinal tumor, or spinal injury. The importance of a team-approach is emphasized. The anesthesiologist may have to anesthetize the pregnant patient for neurosurgery well before delivery, for cesarean delivery at the time of the neurosurgical procedure, or for delivery after neurosurgery. These scenarios are discussed along with fetal safety and anesthetic considerations for interventional neuroradiology.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999