General Anesthesia with Tulip® Supraglottic Airway in a Term Pregnant Patient with Active Herpes Zoster: A Case Report

Herpes zoster, a reactivation of the varicella-zoster virus (VZV), is uncommon during pregnancy but poses significant maternal and fetal risks, necessitating tailored anesthetic management. When neuraxial anesthesia is contraindicated due to lesions located near the insertion site, general anesthesia becomes a reasonable alternative. However, airway management is of paramount importance due to the risk of varicella pneumonia.This case report presents a 39-week pregnant patient with active herpes zoster lesions over the spinal access site who underwent cesarean section under general anesthesia. Airway management was achieved with the Tulip® GT#3 supraglottic airway device, providing a secure and effective alternative to endotracheal intubation. The device was successfully inserted on the first attempt, providing effective ventilation. Aspiration risk was minimized through gastric decompression with an orogastric tube.The postoperative course was uneventful for both mother and newborn. To the best of our knowledge, this is the first reported use of the Tulip Airway in an obstetric patient, highlighting its potential as a safe and effective alternative in appropriately selected cases.