ANESTHETIC MANAGEMENT FOR A COMBINED CESAREAN-SECTION AND POSTERIOR-FOSSA CRANIECTOMY

A 33-year-old primigravida presented with intracranial tumor during th e third trimester of pregnancy. She underwent a ventriculoatrial shunt and a combined cesarean section and posterior fossa craniectomy durin g this period. The neuroanesthetic requirement for this patient is pre vention of rise in intracranial pressure with a slow and smooth induct ion and maintenance. Cesarean section demands rapid induction with min imum anesthetic until the delivery of the baby. Achieving these contra dictory requirements at the same time can be challenging to an anesthe siologist. We report the anesthetic management of this patient during the above surgical procedures. Perioperative management of such patien ts with regard to use of uterine stimulants and prevention of venous s tasis also are discussed.