Secrets of anesthesia in fetoscopic surgery

Publication date: December 2015 Source:Trends in Anaesthesia and Critical Care, Volume 5, Issue 6 Author(s): Ayten Saracoglu, Kemal Tolga Saracoglu, Ibrahim Alatas, Haluk Kafali Certain life-threatening congenital malformations have the opportunity to be treated with minimally invasive fetal surgery. In recent years fetoscopic surgery had a triggered interest. During the fetoscopic surgery all interventions effecting uteroplasental blood flow and eventually fetal oxygenation, may occur as complications like cardiac depression, maternal hypotension or pulmonary edema. Liaise with the increase in cardiac output and heart rate, the pregnant patient may display increased sensitivity to muscle relaxants and inhalational anesthetics. Due to incomplete myelination and synaptic activation, the fetus becomes more sensitive to volatile agents and analgesics. A goal directed therapy is necessary for both maternal and fetal well-being. According to goal directed therapy, perioperative fluid, vasopressor and inotropic agent titration is recommended to be used taking into account the systemic and pulmonary vascular hemodynamics of patients as well as the pulmonary vascular permeability and fluid content. Perioperative anesthesia management with hemodynamic monitorization, airway management and postoperative pain therapy are key features that make up the secrets of anesthesia. The patient's postoperative suffering from pain also leads to fetal and maternal stress by causing uter...
Source: Trends in Anaesthesia and Critical Care - Category: Anesthesiology Source Type: research