Elaborate anesthetic management of cesarean section followed by abdominal radical hysterectomy for uterine cervical cancer: case report

Abstract

Cervical cancer is occasionally detected in pregnant women. If the patient desires the pregnancy, surgical treatment is recommended for cervical cancer at stage IA2 or IB1 when the fetus is mature enough to be delivered. A combination of spinal and epidural anesthesia for cesarean section, followed by general intravenous anesthesia for abdominal radical hysterectomy, was conducted in this case. Two catheters were placed in the upper extremity before anesthesia using ultrasound guidance for invasive arterial pressure monitoring and central venous access. General anesthesia was administered for the abdominal radical hysterectomy under propofol and remifentanil target-controlled infusion to maintain bispectral index at 40–50. Postoperative analgesia was administered via the epidural catheter. The neonate (2475 g) was delivered in 6 minutes, and the Apgar score was 10-10-10 at 1, 5, and 10 minutes. After the surgery, which took 4 h 18 min in total, the patient awakened from anesthesia and was extubated without complications.