JAI (Jurnal Anestesiologi Indonesia) (Nov 2024)
Anesthetic Choice and Management in Cesarean Section for a Patient with Post Laminectomy and Inferior Stabilization: A Case Report
Abstract
Background: Deciding the choice of anesthetic choice and management for a cesarean section is a relatively complex procedure. In this case report we examine a patient undergoing cesarean section who has a significant history of laminectomy with inferior stabilization, the complexities of the patient's conditions may influenced the choice of anesthetic strategy. Case: A 29-year-old female patient undergoing a cesarean section with a complex medical history, including two previous cesarean sections and a laminectomy with inferior stabilization, presenting unique challenges in obstetric and anesthetic care. The patient was admitted to K.M.R.T Wongsonegoro Hospital, Semarang, at 40 weeks of gestation, with symptoms of intense abdominal tightening, active fetal movement, and bloody mucus. Her medical history was further complicated by a laminectomy with inferior stabilization performed in 2019. Discussion: Laminectomy and inferior stabilization is one of the choice treatments for bone tuberculosis. Laminectomy is a surgery that creates space by removing bone spurs and tissues associated with spondylosis of the spine and adding Inferior stabilization to maintain the space. In our patient with complex post-laminectomy and lumbar inferior stabilization, it caused anatomical and neurological changes in the patient. The patient was going to have a cesarean section because the time is nearly expected to be the delivery date of her third pregnancy. Because of the complex background of her past laminectomy surgery, we decided to use the general anesthesia technique for this cesarean section. Conclusion: In this case report we can reaffirm that this case contributes to the medical community's understanding of managing cesarean sections in patients with previous spinal surgeries and underscores the need for evolving clinical guidelines and practices in obstetric anesthesia to enhance patient care and safety. The case is a valuable addition to the literature, providing insights for healthcare professionals in similar complex scenarios.
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