Anesthetic recommendations for maternal and fetal safety in nonobstetric surgery: a balancing act.
| Autor: | Obiyo LT; Department of Anesthesia & Critical Care, University of Chicago, Chicago, Illinois, USA., Tobes D, Cole NM |
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| Jazyk: | angličtina |
| Zdroj: | Current opinion in anaesthesiology [Curr Opin Anaesthesiol] 2024 Jun 01; Vol. 37 (3), pp. 285-291. Date of Electronic Publication: 2024 Feb 23. |
| DOI: | 10.1097/ACO.0000000000001363 |
| Abstrakt: | Purpose of Review: Nonobstetric surgery during pregnancy is associated with maternal and fetal risks. Several physiologic changes create unique challenges for anesthesiologists. This review highlights physiologic changes of pregnancy and presents clinical recommendations based on recent literature to guide anesthetic management for the pregnant patient undergoing nonobstetric surgery. Recent Findings: Nearly every anesthetic technique has been safely used in pregnant patients. Although it is difficult to eliminate confounding factors, exposure to anesthetics could endanger fetal brain development. Perioperative fetal monitoring decisions require an obstetric consult based on anticipated maternal and fetal concerns. Given the limitations of fasting guidelines, bedside gastric ultrasound is useful in assessing aspiration risk in pregnant patients. Although there is concern about appropriateness of sugammadex for neuromuscular blockade reversal due its binding to progesterone, preliminary literature supports its safety. Summary: These recommendations will equip anesthesiologists to provide safe care for the pregnant patient and fetus undergoing nonobstetric surgery. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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