Anesthetic Management of 65 Cases of Ex Utero Intrapartum Therapy: A 13-Year Single-Center Experience.
The anesthetic management for open fetal surgery has been described, but many therapeutic tenets have not been supported with data. We present data on the anesthetic management and outcomes of 65 patients undergoing ex utero intrapartum therapy procedures at the Children's Hospital of Philadelphia between 1998 and 2011. Patients were identified, and medical records were retrospectively reviewed. Maternal general anesthesia combined with postoperative epidural analgesia was commonly used. High levels of volatile anesthetic were used for uterine relaxation. Case characteristics such as fetal procedure, operative time, blood loss, transfusion requirements, vasopressor use, and fetal resuscitative measures are described.
From the *Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; †Department of Obstetrics and Gynecology in Surgery, Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; and Departments of §Pediatric Surgery, ∥Pediatrics, ¶Obstetrics and Gynecology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Elaina E
EE
Lin
Julie S
JS
Moldenhauer
Kha M
KM
Tran
David E
DE
Cohen
N Scott
NS
Adzick
D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D016063:Blood Loss, Surgical; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000601:surgery*; D005333:Fetus / Q000601:surgery*; D005865:Gestational Age; D006776:Hospitals, Pediatric; D006801:Humans; D008499:Medical Records; D061646:Operative Time; D015143:Philadelphia; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014590:Uterine Contraction / Q000187:drug effects; D055815:Young Adult
D018685:Anesthetics, Inhalation