Related Experiment Video
Updated: Jun 9, 2025
05:39
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
1.4K
Anesthetic management for fetal surgery: lessons from a single-center experience (2019-2023)
A Faruja1, A Idelson2, K Azem1
1Department of Anesthesia, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel; Faculty of Medical and Health Sciences, Tel-Aviv University, Tel-Aviv, Israel.
International Journal of Obstetric Anesthesia
|October 23, 2024
Summary
Anesthetic strategies for fetal surgery were refined, improving outcomes by tailoring techniques to procedures. Key changes included better hypotension management and optimized pain control for maternal and fetal safety.
Area of Science:
- Anesthesiology
- Maternal-Fetal Medicine
- Surgical Innovation
Background:
- Fetal surgery requires balancing maternal and fetal safety under anesthesia.
- Anesthetic management for diverse fetal interventions like laser photocoagulation and spina bifida repair presents unique challenges.
Purpose of the Study:
- To evaluate anesthetic management strategies for various fetal interventions.
- To examine the evolution of anesthetic practices and their impact on outcomes.
Main Methods:
- Retrospective review of 195 fetal procedures (2019-2023).
- Analysis of anesthetic techniques, hemodynamic management, and perioperative complications.
- Focus on changes in practice, particularly hypotension control and pain management.
Main Results:
- Spinal anesthesia favored for shorter procedures; general anesthesia for spina bifida repair.
- Prophylactic phenylephrine infusions improved intraoperative blood pressure control.
- Total intravenous anesthesia reduced complications in spina bifida repair; multimodal pain management enhanced recovery.
Conclusions:
- Tailoring anesthetic techniques to specific fetal surgeries is crucial.
- Improvements in hypotension management and anesthesia type enhance maternal-fetal outcomes.
- Continuous adaptation of anesthetic protocols is vital for advancing fetal surgery.
Related Concept Videos
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
414
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
414
01:24General Anesthesia: Overview
196
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
196
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
585
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
585
01:22Stages of General Anesthesia
376
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
376
01:20Inhalational Anesthetics: Overview
217
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
217
01:30Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
977
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
977