ate weakness of the right ankle dorsal and plantar flexions (muscle strength 3 and 4/5, respectively) in the right lower extremity. The Achilles reflex was depressed and pinprick sensation was decreased over the right L5 nerve root dermatome. As magnetic resonance imaging (MRI) demonstrated a central disc herniation at the L5-S1 level, causing severe compression to the right L5 root, surgical decompression was planned on the same day. The obstetricians also evaluated her. According to an ultrasonographic examination, the fetus was healthy, and a fetal heart rate of 140-160 beats·min Ϫ1 was recorded.She was then transported to the operating room, in the lateral decubitis position, where standard monitoring by continuous electrocardiography, noninvasive blood pressure measurement, and oxygen saturation (M1094B; Hewlett Packard, Saronno, Italy) were established. A peripheral venous cannula was also inserted. Before the induction of anesthesia, she was preoxygenated with 6 l·min Ϫ1 oxygen for a period of 5 min. The operating table was maintained in the left tilt position. Induction was achieved with 2 mg·kg Ϫ1 propofol. Vecuronium (0.1 mg·kg Ϫ1 ) was given to facilitate tracheal intubation, with a size 7.5 tube. Anesthesia was maintained with 1%-1.5% sevoflurane in a mixture of oxygen and air (Narkomed; North American Dräger, Telhord, PA, USA) following tracheal intubation. She was placed in the left lateral position and her abdomen was supported with pillows in order to prevent direct pressure on the fetus. Throughout the L5-S1 discectomy operation, which lasted for 2 h, neither fetus nor mother exhibited any hemodynamic change. The fetal heart rate was monitored with Doppler ultrasonography during the induction of anesthesia, emergence, recovery, and whenever possible during surgery. No change was detected in the fetal heart rate (140-160 beats·min Ϫ1 ). At the end of the operation, she was extubated immediately. The postoperative period was smooth and her neurological deficits recovered gradually. Her general
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