Supplementing desflurane with intravenous anesthesia reduces fetal cardiac dysfunction during open fetal surgery

摘要: Objective To lower the incidence and severity of fetal cardiovascular depression during maternal surgery under general anesthesia. Aim We hypothesized that supplemental intravenous anesthesia (SIVA) with propofol remifentanil would need for high-dose inhalational provide adequate depth uterine relaxation. SIVA technique minimize prolonged exposure to deep anesthetics significant intraoperative depression. Background Fetal hypoxia hemodynamic changes occur open because challenges such as surgical manipulation, hysterotomy, contractions, effects anesthetic drugs. Tocolysis, a vital component surgery, is usually achieved using volatile agents. High concentrations agents required an appropriate degree relaxation may cause hypotension placental hypoperfusion, well direct Methods reviewed medical records 39 patients who presented ex utero intrapartum treatment mid-gestation between April 2004 March 2009. Out patients, three were excluded lack echocardiographic data; 18 received high-concentration desflurane had analyzed following data: demographics, condition, drugs, concentration duration desflurane, arterial blood pressure, echocardiogram, presence bradycardia, resuscitation. Results Adequate was about 1.5 MAC in group compared 2.5 only (P = 0.0001). More fetuses developed moderate-severe left ventricular systolic dysfunction over time intraoperatively 0.02). 61% resuscitative interventions 26% 0.0489). Conclusion described provides relaxation, it allows decreased use surgery. Decreased better preserve cardiac function.