“Adnexal masses in pregnancy,” by Mitchel S. Hoffman, MD, and Robyn A. Sayer, MD (March)
I appreciate the information offered by Dr. Hoffman and Dr. Sayer regarding the management of adnexal masses in pregnancy. I have encountered resistance to laparoscopy in pregnant patients from anesthesiologists, who would often prefer laparotomy under regional anesthesia to the general anesthesia required for laparoscopy.
Have the authors encountered this problem?
Eric Rothschild, MD
Fort Lauderdale, Fla
Dr. Hoffman and Dr. Sayer respond: Large series support safety of general anesthesia
We have encountered the same concern from some anesthesiologists at our institution regarding the use of general anesthesia for elective surgery during the first trimester of pregnancy.
The teratogenicity noted in animal studies and anecdotal reports has not been observed in large case series. Most of our anesthesiologists administer general anesthesia in this setting, but avoid certain agents (eg, nitrous oxide).