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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680417 | PMC |
| http://dx.doi.org/10.4103/ija.ija_296_21 | DOI Listing |
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"This is how we do it" Maternal and fetal anesthetic management for fetoscopic myelomeningocele repairs: the Texas Children's Fetal Center protocol.
Int J Obstet Anesth
December 2024
Department of Anesthesiology, Perioperative and Pain Medicine, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States. Electronic address:
Prenatal repair of myelomeningocele (MMC) is associated with lower rates of hydrocephalus requiring ventriculoperitoneal shunt and improved motor function when compared with postnatal repair. Efforts aiming to develop less invasive surgical techniques to decrease the risk for the pregnant patient while achieving similar benefits for the fetus have led to the implementation of fetoscopic surgical techniques. While no ideal anesthetic technique for fetoscopic MMC repair has been demonstrated, we present our anesthetic approach for these repairs, including considerations for both the pregnant patient and the fetus.
View Article and Find Full Text PDFProlonged Ventilator Dependency in a Pediatric ICU Patient With Pfeiffer Syndrome Following Le Fort I Osteotomy and Distraction Osteogenesis: A Case Report.
Cureus
October 2024
Anesthesiology, University of Texas Medical Branch, Galveston, USA.
Pfeiffer syndrome is a rare autosomal dominant disorder characterized by craniosynostosis and midface hypoplasia, often leading to significant airway challenges and respiratory complications during anesthesia management. This case report describes a four-year-old female with Pfeiffer syndrome who underwent Le Fort I osteotomy with distraction osteogenesis and concurrent ventriculoperitoneal shunt revision. Postoperatively, the patient experienced an extended pediatric ICU (PICU) stay with complex airway management, requiring prolonged mechanical ventilation and sedation.
View Article and Find Full Text PDFAnesthetic management of idiopathic intracranial hypertension during pregnancy. A case report.
Rev Esp Anestesiol Reanim (Engl Ed)
November 2024
Servicio de Anestesiología y Reanimación, Hospital Clínic de Barcelona, Barcelona, Spain. Electronic address:
Idiopathic intracranial hypertension (IIH) is a condition characterized by elevated intracranial pressure (ICP) of unknown etiology, more prevalent in obese women of childbearing age. The management of IIH during pregnancy represents a multidisciplinary challenge, as medical treatment is contentious due to the foetal teratogenic risk, and the technically challenging placement of a ventriculoperitoneal shunt is hindered by the presence of the pregnant uterus. The goal of anaesthetic management during childbirth is to maintain hemodynamic stability, cerebral perfusion pressure, and cerebral tissue oxygenation, while avoiding abrupt fluctuations in intracranial pressure.
View Article and Find Full Text PDFArticle Synopsis
- Advances in hydrocephalus treatment are leading to more patients with shunts reaching reproductive age and planning pregnancies.
- Pregnancy complications may arise due to bodily changes like increased water retention and intra-abdominal pressure, necessitating thorough preconception exams and careful management.
- Vaginal delivery is generally deemed safe, while cesarean sections are reserved for cases with significant neurological issues linked to shunt malfunction; various anesthesia options are available in uncomplicated pregnancies.
Anesthetic Strategies and Challenges in the Separation of Pygopagus Conjoined Twins: A Case Report.
Am J Case Rep
October 2024
Department of Anesthesiology, American University of Beirut Medical Center, Beirut, Lebanon.
Article Synopsis
- Conjoined twins, specifically pygopagous twins, present unique surgical and anesthetic challenges, requiring a structured and well-coordinated approach for separation surgeries.
- The case involved female twins conjoined at the sacral level with complex additional conditions, leading to multiple surgeries including meningocele repair and anal canal dilation prior to their separation at 17 weeks of age.
- Successful anesthetic management was achieved through careful planning, effective teamwork, and the use of color-coded systems to minimize errors, demonstrating the importance of detail and communication in complex medical situations.
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