Anaes SAQs · Obstetric anaesthesia
Non-obstetric surgery in pregnancy: appendicectomy at 24 weeks
Final-examination SAQ.
On this page
Study tools
Target exams
ANZCAFRCAEDAICABAFCAI
Prompt
A woman at 24 weeks needs laparoscopic appendicectomy for acute appendicitis. Outline preoperative planning with obstetrics, anaesthetic technique and physiological goals, positioning, and postoperative considerations.
Model answer
Principles (4). Indicated surgery proceeds; second trimester favourable but emergency not delayed; obstetric notification and fetal heart plan.[1]
Conduct (7). Aspiration risk assessment, left uterine displacement, maintain BP/oxygenation/CO2, RSI if indicated, laparoscopy with experienced team and moderated pneumoperitoneum.[2]
Postop (4). Analgesia, VTE prophylaxis, obstetric review for contractions.[2]
References4ShowHide
- [1]ACOG ACOG Committee Opinion No. 775: Nonobstetric Surgery During Pregnancy. Obstet Gynecol, 2019.PMID 30913200
- [2]Reitman E, Flood P Anaesthetic considerations for non-obstetric surgery during pregnancy. Br J Anaesth, 2011.PMID 22156272
- [3]Mushambi MC, Kinsella SM, Popat M, et al. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia, 2015.PMID 26449292
- [4]Lee A, Ngan Kee WD, Gin T A quantitative, systematic review of randomized controlled trials of ephedrine versus phenylephrine for the management of hypotension during spinal anesthesia for cesarean delivery. Anesth Analg, 2002.PMID 11916798