[Anesthetic management for awake laparoscopic surgery for ectopic pregnancy in a patient with heterotopic pregnancy].

A 26-year-old woman with heterotopic pregnancy in the 8th week of gestation was scheduled for surgery for ectopic pregnancy. To reduce the effect on the intrauterine pregnancy, awake laparoscopic surgery was performed under spinal anesthesia with pneumoperitoneum pressure of 6 mmHg. Bilateral shoulder pain occurred when pneumoperitoneum pressure was increased to 8 mmHg. The pain disappeared after the pneumoperitoneum pressure was decreased to 6 mmHg. Attention should be paid to shoulder pain due to physical and chemical stimulation of the diaphragm by pneumoperitoneum. Postoperative pregnancy and delivery were uneventful.