Anesthetic Management in Fetoscopic Surgery and Incidence of Complications

Anesthetic Management in Fetoscopic Surgery and Incidence of Complications - A Retrospective Review

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02434926

Enrollment

152

Registered

2015-05-06

Start date

2015-05-31

Completion date

2016-02-29

Last updated

2023-11-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Anesthetic Complications, Fetoscopy, Pregnancy

Keywords

fetoscopy, fetal surgery, anesthetic complications

Brief summary

Fetoscopic surgery has been acknowledged to be a reliable procedure to correct several congenital anomalies e.g. shunt insertion in fetal bladder outlet obstruction, laser ablation of vessels in twin-twin transfusion syndrome (TTTS), balloon occlusion in congenital diaphragmatic hernia etc. The technique involves an introduction of small-caliber instruments into the amniotic cavity under ultrasound guidance. This procedure can be successfully done under either general anesthesia, regional anesthesia or local anesthesia with sedation. Each technique has both advantages and drawbacks. Several complications related to anesthetic after fetoscopic surgery can occur. For instance, pulmonary edema which is caused by intravenous fluid loading, irrigation fluid absorption or fluid flow through myometrium venous channel. Besides, maternal hypotension intraoperatively can arise from spinal anesthesia. The aim of the study is to report choice of anesthesia using in fetoscopic surgery in the tertiary care institute (Siriraj hospital) and incidence of complications which may relate to different anesthetic techniques.

Detailed description

The quantity and types of medications using in different anesthetic technique will be gathered including opioid, benzodiazepine, propofol, detail of drugs making fetal paralysis, amount of local anesthetic drug in spinal anesthesia etc. Tocolytic drug will also be recorded eg. terbutaline, nifedipine or magnesium sulfate. These drugs have been generally known that may cause hypotension or pulmonary edema. In intraoperative period, the investigators emphasize in the incidence of hypotension and other possible complications such as pulmonary aspiration, failed intubation, maternal desaturation or maternal bradycardia. Volume of intravenous fluid administered and amount of irrigation fluid will also be recorded. Maternal and fetal outcome in recovery room and in postoperative period will be collected.

Interventions

None listed

Study design

Observational model

CASE_ONLY

Time perspective

RETROSPECTIVE

Eligibility

Sex/Gender

FEMALE

Healthy volunteers

Inclusion criteria

* pregnant women who received intrauterine minimally invasive surgery from the past until 30 Nov 2015

Exclusion criteria

* pregnant women who received intrauterine minimally invasive surgery which was not anesthetized by anesthesiologist.

Design outcomes

Primary

Measure	Time frame	Description
Type of anesthetic techniques used in fetoscopic surgery	in operating theatre	Type of anesthetic techniques eg. general anesthesia, regional anesthesia, local anesthesia with sedation.

Secondary

Measure	Time frame	Description
Types and quantity of anesthetic medications used	in operating theatre	Types and quantity of anesthetic medications used for anesthetize patients in different anesthetic techniques.
Incidence of complications	in operating theatre	Intraoperative complications eg. failed intubation, aspiration, hypotension from spinal anesthesia, high spinal block, desaturation etc.

Countries

Thailand

Outcome results