{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T03:30:21Z","timestamp":1780543821361,"version":"3.54.1"},"reference-count":33,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:00:00Z","timestamp":1731715200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Can combined spinal and epidural anesthesia be the gold standard for laparoscopic surgery for pregnant patients? This case report presents a first trimester pregnant patient who was admitted for obstructive jaundice syndrome (pain in the right hypochondrium, nausea, and vomiting). Initially, because of the risk\/benefit ratio of pregnancy, the treatment was medical and the patient was immediately discharged because her clinical condition improved, but she was rapidly readmitted to the surgery department because of worsening symptoms. Emergency surgical intervention (laparoscopic cholecystectomy) under combined spinal and epidural anesthesia (CSEA) was performed to reduce the patient\u2019s risks. Since most analgesics are insufficiently studied in pregnancy, analgesia with ropivacaine 0.2% was used on the epidural catheter. No pathological changes were identified in the fetal Doppler ultrasound preoperatively and postoperatively. Similarly to other studies, our case highlights the necessity for cholecystectomy for acute cholecystitis even if the patient is in the first trimester of pregnancy. If the decision is delayed, the morbidity and mortality for mother and fetus become unjustified. The peculiarity of the present report is the type of anesthesia chosen. We consider that combined spinal and epidural anesthesia may become a possible gold standard suitable for laparoscopy in the first trimester of pregnancy.<\/jats:p>","DOI":"10.3390\/life14111492","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T05:36:45Z","timestamp":1731908205000},"page":"1492","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Laparoscopic Cholecystectomy Under Combined Spinal and Epidural Anesthesia in the First Trimester of Pregnancy\u2014Case Report and Literature Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5340-8929","authenticated-orcid":false,"given":"Gabriel-Petre","family":"Gorecki","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care, Faculty of Medicine, \u201cTitu Maiorescu\u201d University, 031593 Bucharest, Romania"},{"name":"Department of Anesthesia and Intensive Care, CF2 Clinical Hospital, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7583-2703","authenticated-orcid":false,"given":"Andrei","family":"Bodor","sequence":"additional","affiliation":[{"name":"1st Department of Cardiovascular Anesthesiology and Intensive Care, Prof. Dr. C. C. Iliescu Emergency Institute for Cardiovascular Diseases, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoltan-Janos","family":"K\u00f6v\u00e9r","sequence":"additional","affiliation":[{"name":"Department of General Surgery, CF2 Clinical Hospital, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Mihaela","family":"Com\u0103nici","sequence":"additional","affiliation":[{"name":"Department of Immunology, Faculty of Medicine, \u201cTitu Maiorescu\u201d University, 031593 Bucharest, Romania"},{"name":"Department of Clinical Immunology and Molecular Biology, CF2 Clinical Hospital, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9541-3347","authenticated-orcid":false,"given":"Romina-Marina","family":"Sima","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Obstetrics and Gynecology, The \u201cBucur\u201d Maternity, \u201cSaint John\u201d Hospital, 040294 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9213-6735","authenticated-orcid":false,"given":"Anca-Maria","family":"Panaitescu","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Obstetrics and Gynecology, Filantropia Clinical Hospital Bucharest, 011171 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian-Vasile","family":"Com\u0103nici","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Faculty of Medicine, \u201cTitu Maiorescu\u201d University, 031593 Bucharest, Romania"},{"name":"Department of Endocrinology, CF2 Clinical Hospital, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia","family":"Furdu-Lungut","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, \u201cTitu Maiorescu\u201d University, 031593 Bucharest, Romania"},{"name":"Department of Neurology, CF2 Clinical Hospital, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6742-6334","authenticated-orcid":false,"given":"Ancuta-Alina","family":"Constantin","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"\u201cMarius Nasta\u201d National Institute of Pneumology, 90 Viilor Street, 050159 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liana","family":"Ple\u0219","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Obstetrics and Gynecology, The \u201cBucur\u201d Maternity, \u201cSaint John\u201d Hospital, 040294 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8028-2527","authenticated-orcid":false,"given":"Andrei Sebastian","family":"Diaconescu","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"General Surgery Department, Fundeni Clinical Institute, 022328 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasile","family":"Lungu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, CF2 Clinical Hospital, 011464 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.bjae.2022.12.001","article-title":"Anaesthesia for Non-Obstetric Surgery during Pregnancy","volume":"23","author":"Brakke","year":"2023","journal-title":"BJA Educ."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e113","DOI":"10.3346\/jkms.2020.35.e113","article-title":"Factors Affecting Maternal and Fetal Outcomes of Non-Obstetric Surgery and Anesthesia during Pregnancy: A Retrospective Review of Data at a Single Tertiary University Hospital","volume":"35","author":"Cho","year":"2020","journal-title":"J. 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