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J Matern Fetal Neonatal Med. 2013 Jan;26(2):158-60. doi: 10.3109/14767058.2012.722733. Epub 2012 Sep 18.

Success rate and challenges of fetal anesthesia for ultrasound guided fetal intervention by maternal opioid and benzodiazepine administration.

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  • 1Department of Anesthesiology, Kyorin University School of Medicine, Shinkawa, Mitaka, Japan.

Abstract

OBJECTIVE:

The safe and effective methods of fetal anesthesia/analgesia during ultrasound guided direct fetal procedure are yet to be determined. The authors investigated whether maternal diazepam/fentanyl administration meets this purpose.

METHODS:

The medical/anesthesia records were retrospectively reviewed in cases between 2001 and 2010 at a tertiary perinatal center. Success rate as well as maternal and fetal complications were analysed.

RESULTS:

Among the 150 procedures in 118 fetuses, diazepam 10 mg and fentanyl 200 µg sufficiently prevented fetal movement upon the procedure in 56% of the procedures. Supplemental anesthetic agents such as nitrous oxide and propofol were needed in other cases. No serious maternal complication was noted, while fetal cardiac arrest/severe bradycardia was noted in three fetuses, one of which was successfully resuscitated by intracardiac adrenalin injection.

CONCLUSIONS:

Maternal diiazepam/fentanyl administration offered adequate fetal condition without significant maternal complications. Since these procedures are performed to treat severe fetal conditions, preparation for fetal resuscitation is also important.

PMID:
22928538
[PubMed - indexed for MEDLINE]
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