Management of the pregnant woman with an acute abdomen is a typical multidisciplinary challenge. Regardless of the type of surgery and anesthesia, close cooperation and communication between surgeons, anesthesiologists, obstetricians, radiologists, the intensivist, as well as nurses and midwives, is essential. Non-obstetric causes of acute abdomen in pregnancy include appendicitis, bowel obstruction, inflammatory bowel disease, spontaneous esophageal rupture, peptic ulcer disease and perforated gastric ulcer, cholecystitis and pancreatitis. Obstetric causes of acute abdomen involving liver are spontaneous hepatic rupture, ruptured splenic artery aneurysm and aortic aneurysm. Nephrolithiasis, or kidney stones, is uncommon in pregnancy. Careful preoperative assessment of the woman should be made and all preparative measures taken in order to minimize the risk and possible harm of the anesthetic procedure. For major abdominal surgery, the use of epidural analgesia is safe and beneficial provided there is a stable hemodynamic situation.

The posterior fossa is an intracranial compartment that houses the cerebellum and the brainstem. Mass lesions and increased intracranial pressure (ICP) in this area can have profound consequences for neurologic, cardiac, and respiratory functions. This chapter presents a case study of a 54-year-old female with complaints of headaches, progressive hearing loss and episodes of aspiration that were increasing in frequency. A diagnosis of neurofibromatosis type 2 was made and a posterior fossa craniotomy was scheduled. Immediate concerns for the anesthetic team included (1) a depressed level of consciousness, (2) the potential for increased ICP, and (3) aspiration on induction. Neurosurgical procedures involving the posterior fossa can be challenging for both the surgical and anesthetic teams. Preoperative assessment and preparation of these patients should focus on the consequences of posterior fossa abnormalities as well as the potentially life-threatening complications that may occur intraoperatively.

Pediatric surgical patients present special anesthetic challenges including induction without intravenous (IV) access, a higher incidence of airway complications, and a greater incidence of hemodynamic instability due to surgical blood loss. Supratentorial tumors are the second most common location and include low-grade astrocytoma, malignant and mixed glioma, ependymoma, ganglioglioma, oligodendroglioma, choroid plexus tumor, and meningioma. This chapter presents a case study of a 8-year-old child presented with partial complex seizures characterized by staring spells accompanied by oral and manual automatisms. Preoperative evaluation (magnetic resonance imaging) demonstrated a non-enhancing heterogeneous lesion in the mesial aspect of the right temporal lobe consistent with lowgrade glial neoplasm. A neurologic assessment was performed after extubation and it showed no neurologic deficits. Subsequently the patient was transported to the pediatric intensive care unit where his recovery was satisfactory. Anticonvulsant medications should be continued and administered the day of surgery to prevent intraoperative and postoperative seizures.