title: Anesthetic Techniques and Incidence of Complications in Fetoscopic Surgery.
abstract: BACKGROUND
  Nowadays, fetoscopic surgery has been accepted to be a procedure to correct numerous congenital anomalies. This operation can be successfully done under general, regional or local anesthesia with sedation. Incidence of complications from anesthesia in fetoscopic surgery has not been reported in Thailand.
  
  
  OBJECTIVE
  To describe anesthetic techniques and incidence of complications in fetoscopic surgery.
  
  
  METHODS
  Data of 152 pregnant women undergoing fetoscopic surgery in a single university hospital was retrospectively chart reviewed from June 2005 to November 2015. Patient characteristics, choices of anesthesia, medication used, intraoperative data and complications were collected.
  
  
  RESULTS
  During the study period, spinal anesthesia was the most popular technique used in fetoscopic surgery (71%). Other anesthetic techniques used were general anesthesia with endotracheal tube (GA) (20.5%), epidural anesthesia (1.3%), combined spinal and epidural anesthesia (0.7%), failed spinal anesthesia converting to GA (2.6%) and local anesthesia with sedation (3.9%). Most frequent anesthetic-related complication was maternal hypotension which occurs in 115 out of 152 patients (75.6%). All of 5 cases (3.3%) of postoperative pulmonary edema received SA. Fetal death after operation was 25 in 152 records (16.4%). None of patients received GA experienced desaturation, pulmonary aspiration, failed intubation or pulmonary edema.
  
  
  CONCLUSIONS
  Spinal anesthesia (SA) is the most frequent technique used for fetoscopy, and hypotension is the most common complication. Since pulmonary edema was also found, judicious perioperative fluid management should be implemented to prevent postoperative pulmonary edema.
authors: Patchareya
authors: P
authors: Nivatpumin
authors: Pawinee
authors: P
authors: Pangthipampai
authors: Tachawan
authors: T
authors: Jirativanont
authors: Sukanya
authors: S
authors: Dej-Arkom
authors: Namtip
authors: N
authors: Triyasunant
authors: Thongchai
authors: T
authors: Tempeetikul
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000379:methods*; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000775:Anesthesia, Spinal; D005260:Female; D005332:Fetoscopy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D012189:Retrospective Studies