Peridurale Anästhesie zur Fetoskopie

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• 作者：N. Kiefer ; S. F. Suter ; C. Berg ; U. Gembruch ; S. U. Weber
• 关键词：SchlüsselwörterFetoskopie ; Periduralanästhesie ; Blutdruck ; Kardiotokografie ; Pränatale Therapie
• 刊名：Der Anaesthesist
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：66
• 期：1
• 页码：28-33
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Anesthesiology; Emergency Medicine; Intensive / Critical Care Medicine; Pain Medicine;
• 出版者：Springer Medizin
• ISSN：1432-055X
• 卷排序：66

文摘

BackgroundThe introduction of routine prenatal screening using ultrasound has led to a substantial increase in diagnoses of fetal disorders that are amenable to intrauterine treatment. While an ultrasound guided insertion of small bore cannulas can be performed under local anesthesia, insertion of a fetoscope usually requires anesthetic management for the mother and the fetus. Additionally, the fetus’ intrauterine position may have to be manipulated in order to enable access. Such manoeuvres depend on relaxation of the mother’s abdominal wall. General anesthesia has been the preferred method, but it involves substantial risks both to the mother and possibly the fetus, especially when combined with aggressive uterine relaxation. Epidural anesthesia (EA) may provide an alternative. Only little systematic data on the efficacy, requirements or untoward effects of epidural anesthesia for fetoscopy exists in the literature, yet a high rate of arterial hypotension following EA has been reported. We therefore aimed to assess the hemodynamic reaction to EA in a mixed population of pregnant women undergoing fetoscopy for a variety of fetal conditions and performed a retrospective analysis of a one-year cohort in a single university hospital.