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CASE REPORT
Year : 2018  |  Volume : 7  |  Issue : 2  |  Page : 74-76

Renal Cell Carcinoma in Pregnancy: Radical Nephrectomy and the Use of Dexmedetomidine


Department of Anesthesiology and Intensive Care, Dr. Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, Central Health Services, New Delhi, India

Correspondence Address:
Dr. Uma Hariharan
MBBS, DNB, PGDHM, Assistant Professor, Anesthesiology and Intensive Care, Fellowship Oncoanesthesia and Advanced Regional Anesthesia, BH – 41, East Shalimar Bagh, New Delhi – 110 088
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ccij.ccij_75_17

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Renal cell carcinoma is sinister cancer, uncommon during pregnancy. A 26-week period of gestation, primigravida pregnant women presented with painless hematuria and left flank fullness. She was found to have left-sided renal cell carcinoma, with no metastasis or vascular invasion. All her preoperative investigations were within normal limits, except for mild anemia. An obstetric evaluation was unremarkable, with normal fetal heart sounds. Perioperative care of pregnant patients for oncosurgery poses great challenges, affecting both the mother and the fetus. Preoperative tocolytic therapy was started to prevent preterm labor, and an obstetrician was kept standby during surgery. A combined general anesthesia with rapid sequence induction and cricoid pressure along with preinduction epidural catheter was administered, followed by the insertion of invasive monitoring lines. Dexmedetomidine use is also highlighted, as it has several beneficial effects and has been safely used in pregnant patients. The tumor was successfully removed, and the patient was transferred to the high-dependency-care unit after extubation. We hereby describe the perioperative anesthetic challenges in this unique case report.


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