Key result
Multimodal anesthesia maintains hemodynamic stability and controls pain across three simultaneous major surgeries.
Why the study?
Patients undergoing multiple major surgeries require thorough anaesthesia management to ensure safety and surgical success, but detailed perioperative strategies are not well described.
Case Report (n=1)
No
Careful perioperative anaesthesia management, including multimodal analgesia and fluid therapy, is crucial for maintaining stability and preventing complications in patients undergoing multiple simultaneous major surgeries.
Supports feasibility of multimodal anesthesia for triple major surgery in select cases; leaves open generalizability pending larger prospective trials.
Background: Major surgery lacks a universally clear definition. The European Surgical Association (ESA) defines it based on factors like patient comorbidities, procedure complexity, and clinical outcomes. Globally, surgery-related one-year mortality is about 5–6%, rising to 14% in frail patients. Laminectomy, laparotomy, and myomectomy is classified as major surgeries, each with significant risks such as bleeding, infection, and readmission. When combined, these surgeries require thorough anaesthesia management to ensure patient safety and surgical success. Objective: The purpose of this study was to give a deep understanding of the case, identify key issues and solutions, and present insight for future action. Methods: Data were collected through direct observation and patient medical records, covering the period from before surgery to three days post-operation. This included medical history, test results, and detailed treatment records. Results: Haemodynamic stability and intraoperative bleeding were well managed and anticipated. Careful repositioning was carried out, partly to maintain airway patency. The patient reported mild postoperative pain and was able to start sitting and walking exercises three days after the surgery. Conclusion: Patients undergoing multiple surgeries require careful monitoring and personalised anaesthetic management. Maintaining physiological stability, proper positioning, and effective fluid and pain control are key to preventing complications.
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Gemawan et al. (2026) conducted a case report in Presacral Tumor, Herniated Nucleus Pulposus, and Leiomyoma (n=1). Perioperative anaesthesia management strategy (multimodal anaesthesia, fluid management, positioning) was evaluated on Haemodynamic stability, intraoperative bleeding, and postoperative pain. Multimodal perioperative anaesthesia management successfully maintained haemodynamic stability and managed postoperative pain in a patient undergoing three simultaneous major surgeries.
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