[Propofol anesthesia for fetal sedation].
We were requested to reduce neonatal respiratory effort at delivery in anesthetic management for Cesarean section. A 26-year-old pregnant woman was suspected through abdominal ultrasound examination and amniotic fluid test, of her baby having immature lungs associated with remarkable pleural effusion. Lungs could be damaged by respiratory effort after delivery, and respiratory management immediately after delivery was planned. Anesthesia was induced with propofol and fentanyl 300 micrograms. Propofol was administered with a target controlled infusion setting with the target blood concentration of 10 micrograms.ml-1. Fetal electrocardiogram was monitored for detecting fetal sedation. The concentrations of propofol at delivery were 10.7 and 4.1 micrograms.ml-1 in maternal arterial and umbilical venous blood, respectively, and the baby was apneic. Respiration of the baby was managed with a high frequency jet ventilation mode, and 160 ml of pleural effusion was aspirated immediately after the delivery. The baby was discharged from the hospital 5 weeks afterward.
Kubo
Kozue
K
Department of Anesthesiology, Kansai Medical University Hospital, Moriguchi 570-8506.
Murao
Kohei
K
Takeyasu
Akiko
A
Ohashi
Atsushi
A
Nakao
Shin-ichi
S
Shingu
Koh
K
D000328:Adult; D000771:Anesthesia, Intravenous; D000773:Anesthesia, Obstetrical; D018686:Anesthetics, Intravenous / Q000097:blood; D002585:Cesarean Section; D016292:Procedural Sedation / Q000379:methods*; D005260:Female; D005283:Fentanyl; D005333:Fetus; D006611:High-Frequency Jet Ventilation; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000002:abnormalities / Q000196:embryology; D008171:Lung Diseases / Q000196:embryology / Q000628:therapy; D010996:Pleural Effusion / Q000196:embryology / Q000628:therapy; D011247:Pregnancy; D015742:Propofol / Q000097:blood; D013396:Suction
D018686:Anesthetics, Intravenous; D005283:Fentanyl; D015742:Propofol