title: The use of potent inhalational agents for the ex- utero intrapartum treatment (exit) procedures: what concentrations?
abstract: The anesthetic management of a parturient undergoing ex-utero intrapartum treatment (EXIT) procedures for airway control of a newborn with a potentially life-threatening difficult airway is complex and often challenging. We herein report on the successful anesthetic management of the EXIT procedure in a 30-year-old primigravida carrying a fetus with large cervical lymphangioma. General anesthesia was maintained with sevoflurane 2%, combined with continuous infusion of nitroglycerine (TNG). Although the use of high concentrations of potent inhalational agents (to keep the uterus fully relaxed) is currently recommended we believe that the use of low concentrations of potent inhalational anesthetics with continuous infusion of TNG may be a safer anesthetic strategy for these operations.
authors: Department of Anesthesiology, Kitasato University School of Meidicine, Sagamihara, Kanagawa, Japan. toshiyukiokutomi@hotmail.com
authors: T
authors: T
authors: Okutomi
authors: M
authors: M
authors: Saito
authors: K M
authors: KM
authors: Kuczkowski
mesh_terms: D000328:Adult; D000758:Anesthesia; D018685:Anesthetics, Inhalation; D002585:Cesarean Section; D004562:Electrocardiography; D005260:Female; D005333:Fetus / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008202:Lymphangioma / Q000601:surgery; D008279:Magnetic Resonance Imaging; D005996:Nitroglycerin / Q000494:pharmacology; D011247:Pregnancy; D013125:Spinal Neoplasms / Q000601:surgery; D014665:Vasodilator Agents / Q000494:pharmacology
chemical_list: D018685:Anesthetics, Inhalation; D014665:Vasodilator Agents; D005996:Nitroglycerin