孕期微创手术中胎儿的麻醉方法:附6例次报告

Fetal Anesthesia Methods for Minimally Invasive Surgery during Pregnancy:Six Cases Report

目的:探讨孕期微创手术中安全有效的胎儿麻醉方法。方法:回顾分析6例次接受宫内输血术的胎儿及母体的一般资料、麻醉用药、给药途径、术中监测情况等相关资料。结果:6例次孕期微创手术、胎儿麻醉操作均成功,其中1例次孕期微创手术采用母体静脉麻醉,术中胎儿胎动频繁、胎心率较快,影响操作;4例次采用胎儿静脉注射麻醉以及1例次采用胎儿肌内注射麻醉的胎儿胎动控制良好。应用肌松药可抑制胎动,加用镇痛药可维持胎心率平稳。结论:对于接受孕期微创手术的胎儿,建议应用肌松药;对于孕中期的胎儿,则推荐加用阿片类镇痛药。

Objective：To explore the fetal anesthesia method which is safe and effective for minimally invasive surgery during pregnancy.Methods：The clinical datum including general information,anesthetic medication,administration route and intraoperative monitoring of 6 cases of fetal intrauterine transfusion were retrospectively analyzed.Results：The minimally invasive surgery during pregnancy and its fetal anesthetic operation of the 6 cases were all successful.One case of minimally invasive surgery during pregnancy was given maternal intravenous anesthesia,of which operation was affected by frequent fetal movement during operation and fast fetal heart rate.In 4 cases given fetal intravenous anesthesia and 1 case given fetal intramuscular injection,the fetal movement was well controlled.Concomitant muscle relaxants could inhibit fetal movement,and concomitant analgesics could maintain steady fetal heart rates.Conclusions：The muscle relaxants are recommended for fetus who underwent minimally invasive surgery during pregnancy and opioid analgesics are recommended for fetus during second pregnancy trimester.