Hypotension à l'isoflurane pour cure d'anévrysme intracrânien en fin de grossesse

Maissin, F.; Mesz, M.; Roualdes, G.; Bataille, B.; Criscuolo, J.L.

doi:10.1016/s0750-7658(87)80372-6

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…Maissin et al 7 reported a similar case in the 31st gestational week. After induction with fentanyl, atropine, and thiopental, FHR oscillations were reduced from 5 to 10 to 2 beats/min.…”

Section: Discussionmentioning

confidence: 85%

“…Although controlled hypotension in pregnant patients has a risk of reducing placental blood flow, it has been used by a number of authors. 2 -5 - 7 These authors all monitored the effects of anaesthesia and hypotension on the FHR. Minielly et al 2 described seven cases of continuous peroperative FHR monitoring during clipping of a cerebral aneurysm.…”

Section: Discussionmentioning

confidence: 99%

“…Minielly et al 2 advocate the use of trimethaphan as drug of choice for induction of 185 hypotension in pregnant patients without giving any argument for their statement. Newman and Lam 5 and Maissin et al 7 used isoflurane as the hypotensive agent.…”

Section: Discussionmentioning

confidence: 99%

“…After neurosurgical treatment, the mortality is reduced to 8%. 14 Intracranial surgery has been performed successfully in pregnancy, either under hypothermia 14 to reduce the cerebral metabolism, or under controlled hypotension 2 -5 - 7 to reduce the intra-arterial pressure. Most authors agree that fetal heart rate (FHR) monitoring is valuable in detecting fetal distress, although changes in the FHR (variability) can also be caused by effects of the anesthetic drugs used.…”

mentioning

confidence: 99%

See 3 more Smart Citations

General Anesthesia for Surgical Repair of Intracranial Aneurysm in Pregnancy: Effects on Fetal Heart Rate

Buul

Nijhuis²,

Slappendel³

et al. 1993

Amer J Perinatol

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A 30-year-old nulliparous woman underwent surgery for a ruptured aneurysm of the left vertebral artery in gestational week 27. The fetal heart rate (FHR) was monitored continuously with an abdominal Doppler transducer. Anesthesia was induced with midazolam, fentanyl, and thiopental and maintained with fentanyl, isoflurane, and nitrous oxide 67% in oxygen. Surgery was performed under moderate hypotension (mean arterial pressure +/- 70 mmHg) and moderate hyperventilation (arterial carbon dioxide pressure +/- 33 mmHg). There was a complete disappearance of FHR variability without decelerations or bradycardia. In the night following surgery, the patient was sedated with large parenteral doses of midazolam and fentanyl. Despite this sedation, some FHR variability reappeared within 40 minutes after discontinuation of the inhalation anesthetics. After discontinuation of parenteral midazolam and fentanyl, normal FHR variability returned within 60 minutes. In week 41 of pregnancy, a healthy girl of 4015 gm was born.

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“…Maissin et al 7 reported a similar case in the 31st gestational week. After induction with fentanyl, atropine, and thiopental, FHR oscillations were reduced from 5 to 10 to 2 beats/min.…”

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%