Anestesia para tratamento intraparto extra-útero em feto com diagnóstico pré-natal de higroma na região cervical: relato de caso

Anestesia para tratamento intraparto extraútero (EXIT) em fetos com diagnóstico pré-natal de malformações cervical e oral: relato de casos

“…When the fetus changes to the adult-type circulation, he begins to depend on his own pulmonary ventilation and oxygenation, therefore, limiting the time to secure access to the airways 14,22 . In order to avoid fetal movements and breathing efforts, it is possible to administer opioids and muscle relaxants within a muscle 7,14,22 .…”

“…In order to avoid fetal movements and breathing efforts, it is possible to administer opioids and muscle relaxants within a muscle 7,14,22 .…”

“…Therefore, it is important to administer halogenated anesthetics in uterolytic doses, but without jeopardizing the mother's cardiovascular system. If the mother's AP lowers, it must be immediately corrected with vasoconstrictor agents (ephedrine and phenylephrine) 17,22 . On the other hand, the umbilical cord blood flow depends on the fetal circulation.…”

“…During the procedures, fetal oxygenation was appropriate. According to the studies presented, total time from uterus incision and umbilical cord clamping should be limited to 60 minutes, but ideally time gap should be less than 30 minutes 2,22 .…”

“…It can be used in intermittent bolus of 50 to 100 µg through venous access or in continuous infusion of 10 to 20 µg.kg -1 .min -1 22,33 . Despite being ideal for EXIT procedures, nitroglycerin can cause hypotension and must be readily corrected with vasoconstrictor agents to maintain uterine perfusion 22,33 . Magnesium sulfate can also be used in bolus of 2 to 3 g through venous access and maintenance of continuous infusion of 2 g.h - 1 29,34 .…”