Prise en charge anesthésique de la femme enceinte pour cœliochirurgie gynécologique non obstétricale à la maternité de Clermont-Ferrand

Abstract

Objective. – To evaluate the anaesthetic management intended for pregnant women in the field of non obstetric and gynaecologic laparoscopic surgery. Study design. – Retrospective and monocentric investigation. Patients and methods. – Analysis of the anaesthetic and obstetric files from 27 pregnant women operated on in the establishment, between January 2001 and July 2004. Results. – 27 female patients involved in the study. The mean pregnancy term was 15 weeks when laparoscopic surgery was performed, though a single patient was at 30 weeks. The average duration of the surgery was 61 minutes, of which 28 minutes were dedicated to pneumoperitoneum. Twenty-four patients underwent general anaesthesia, the three others underwent locoregional anaesthesia. During the perioperative period no surgical, anaesthetic or obstetric complications were observed. Conclusion. – Laparoscopic surgery during pregnancy requires double skilled management, both in anaesthesiology and obstetrics. On haemodynamics and breathing, pneumoperitoneum does not induce any additional effects when compared to operations without pregnancy. Except with delivery cases, anaesthetic support in laparoscopic surgery intended for pregnant women eventually does not generate any specific problems, but requires the same rigorous management as the one usually following surgery for pregnant patients.