ANESTHESIOLOGICAL MANAGEMENT OF FETOSCOPIC LASER COAGULATION OF PLACENTAL ANASTOMOSES IN TWIN-TO-TWIN TRANSFUSION SYNDROME
https://doi.org/10.18705/2311-4495-2019-6-1-43-50
Abstract
In this study we presented the analysis of regional anesthesia (epidural and spinal) effectiveness in 72 fetoscopic laser coagulation (FLC) of placental anastomoses, performed in Saint Petersburg Maternity hospital № 17. In 2008 FLC was performed under epidural anesthesia and average time of procedure was 120 minutes, in 2017 according the rising surgical experience the time of procedure reduced to 33 (23–37.5) minutes, that allowed start to use spinal anesthesia. Conclusions: regional methods (epidural and spinal) manage adequate level of anesthesia. Rising surgical experience and reducing the time of procedure to 33 (23–37.5) minutes allowed to use spinal anesthesia successfully. In 29.2 % of cases of regional anesthesia intraoperative arterial hypotension was observed but was successfully corrected by moderate vasopressors doses. No other anesthesiological maternal complications were observed, which confirming safety of regional anesthesia in fetoscopic laser coagulation of placental anastomoses.
About the Authors
E. A. Murieva
Saint Petersburg State “Maternity Clinic № 17”
Russian Federation
Murieva Elona A., MD, PhD, Chief of Department of Anesthesiology and Reanimatology
Russian Federation
Murieva Elona A., MD, PhD, Chief of Department of Anesthesiology and Reanimatology
A. V. Mikhailov
Saint Petersburg State “Maternity Clinic № 17”;
North-Western State Medical University named after I. I. Mechnikov;
Pavlov First Saint Petersburg State Medical University
Mikhailov Anton V., MD, DSc, Professor, Director and Chief of
Chief of Department of Women’s Reproductive Health
Chief Obstetrician-gynecologist
A. N. Romanovsky
Saint Petersburg State “Maternity Clinic № 17”;
North-Western State Medical University named after I. I. Mechnikov
Russian Federation
Russian Federation
Romanovsky Artem N., MD, Maternity Department Doctor
Assistant of Department of Women’s Reproductive Health
T. A. Kashtanova
Saint Petersburg State “Maternity Clinic № 17”
Kashtanova Tatiana A., MD, Chief of Department of Prenatal Diagnostics
Kashtanova Tatiana A., MD, Chief of Department of Prenatal Diagnostics
A. A. Kuznetsov
Saint Petersburg State “Maternity Clinic № 17”;
Pavlov First Saint Petersburg State Medical University
Kuznetsov Alexander A., MD, Maternity Department Doctor
PhD Student of Obstetrics and Gynecology Department
I. V. Kyanksep
Saint Petersburg State “Maternity Clinic № 17”
Kyanksep Inna V., MD, Doctor of Department of Prenatal Diagnostics
Kyanksep Inna V., MD, Doctor of Department of Prenatal Diagnostics
A. V. Shlykova
Saint Petersburg State “Maternity Clinic № 17”;
North-Western State Medical University named after I. I. Mechnikov
Anna V. Shlykova, MD, Maternity Department Doctor
PhD Student of Obstetrics and Gynecology Department of S. N. Davydov
V. E. Movchan
Saint Petersburg State “Maternity Clinic № 17”;
North-Western State Medical University named after I. I. Mechnikov
Movchan Veronika E., Resident of Obstetrics and Gynecology Department of S. N. Davydov
Movchan Veronika E., Resident of Obstetrics and Gynecology Department of S. N. Davydov
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Review
For citations:
Murieva E.A., Mikhailov A.V., Romanovsky A.N., Kashtanova T.A., Kuznetsov A.A., Kyanksep I.V., Shlykova A.V., Movchan V.E. ANESTHESIOLOGICAL MANAGEMENT OF FETOSCOPIC LASER COAGULATION OF PLACENTAL ANASTOMOSES IN TWIN-TO-TWIN TRANSFUSION SYNDROME. Translational Medicine. 2019;6(1):43-50. (In Russ.) https://doi.org/10.18705/2311-4495-2019-6-1-43-50
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