Anaesthetic Management of a Complicated Bilateral Tubo-Ovarian Abscess Posted for Diagnostic Laparoscopy followed by Laparotomy

ABSTRACT

A middle aged female presented with abdominal distension due to tubo ovarian abscess compressing both ureters leading to Acute Kidney Injury and reactive pleural effusion posted for diagnostic laproscopy and laparotomy done under general anaesthesia with Rapid Sequence Induction. The aims of anaesthetist during surgery were 1) To maintain hemodynamic stability and prevent regurgitation. 2) To provide optimum analgesia intraoperatively and post operatively and 3) To maintain Peak Airway Pressure within normal limits to prevent the basal lung atelectasis. Intra-operatively hemodynamic vitals were monitored and airway pressures were maintained within normal limits. Intra operatively laryngospasm occurred that was treated with i.v. succinylcholine and regurgitated contents were suctioned immediately. Patient was uneventfully managed and underlying pathology was corrected. Post-operatively; patient was shifted to ICU with endotracheal tube in situ that was weaned off eventually and successfully. Thus finally meticulous and collaborative efforts of Anesthesiologist, Gynecologist and para-medical staff, such critical patient can be well managed pre, intra and postoperatively uneventfully.