Advertisement

Anesthesia for Surgery in the Pregnant Surgical Patient

  • A. M. Malinow
  • J. W. Ostheimer
Part of the Developments in Critical Care Medicine and Anesthesiology book series (DCCA, volume 30)

Abstract

Anesthetic management of the pregnant surgical patient must address the well-being of both mother and fetus. The patient’s surgical condition, pregnancy-induced physiologic changes, and possible adverse effects (both direct and indirect) of anesthesia all have a bearing on anesthetic management. Attention must be paid to the duration of the planned surgical procedure, the possible sequelae from anesthesia and surgical intervention, the condition of the pregnancy, and the gestational age and viability of the fetus.

Keywords

Nitrous Oxide Minimum Alveolar Concentration Inhalational Agent Uterine Blood Flow Uterine Tone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Smith BE: Fetal prognosis after anesthesia during gestation. Anesth Ana1g 42:521, 1963Google Scholar
  2. 2.
    Shnider SM, Webster GM: Maternal and fetal hazards of surgery during pregnancy. Am J Obstet Gynecol 92:891, 1965PubMedGoogle Scholar
  3. 3.
    Brodsky JB, Cohen EN, Brown BW et al: Surgery during pregnancy and fetal outcome. Am J Obstet Gynecol 138:1165, 1980PubMedGoogle Scholar
  4. 4.
    Konieczko KM, Chapk JC, Nunn JF: Fetotoxic potential of general anesthesia in relation to pregnancy. Brit J Anaesth 59:449, 1987PubMedCrossRefGoogle Scholar
  5. 5.
    Weingold AB, ed: Surgical diseases in pregnancy. Clin Obstet Gynecol 24(4):793,1983CrossRefGoogle Scholar
  6. 6.
    Duncan PG, Pope WDB, Cohen MM et al: Fetal risk of anesthesia and surgery during pregnancy. Anesthesiology 64:790, 1986PubMedCrossRefGoogle Scholar
  7. 7.
    Mazze RI, Kallen B: Reproductive outcome after anesthesia and operation during pregnancy: A registry study of 5405 cases. Am J Obstet Gynecol 161:1178, 1989PubMedGoogle Scholar
  8. 8.
    Mazze RI, Fujinaga M, Rice SA et al: Reproductive and teratogenic effect of nitrous oxide, halothane, isoflurane and enflurance in Sprague-Dawley rats. Anesthesiology 64:339, 1986PubMedCrossRefGoogle Scholar
  9. 9.
    Nunn JF: Clinical aspects of the interaction between nitrous oxide and vitamin B12. Brit J Anaesth 59:3, 1987PubMedCrossRefGoogle Scholar
  10. 10.
    Fujinaga M, Mazze RI, Baden JM: Reconsiderations of the mechanisms of nitrous oxide teratogenicity. Anesthesiology 69:A658, 1988CrossRefGoogle Scholar
  11. 11.
    Crawford JS, Lewis M: Nitrous oxide in early human pregnancy. Anaesthesia 41:900, 1986PubMedCrossRefGoogle Scholar
  12. 12.
    Keeling PA, Rocke DA, Nunn JF et al: Folinic acid as protection against nitrous oxide teratogenicity in the rat. Brit J Anaesth 58:528, 1986PubMedCrossRefGoogle Scholar
  13. 13.
    Marx GF: The N2O dilemma. Obstet Anesth Dig 5:126, 1985CrossRefGoogle Scholar
  14. 14.
    Fujinaga M, Baden JM, Yhap EO et al: Reproductive and teratogenic effects of nitrous oxide, isoflurane, and their combination in SpragueDawley rats. Anesthesiology 67:960, 1987PubMedCrossRefGoogle Scholar
  15. 15.
    Biehl DR, Yarnell R, Wide JG et al: The uptake of isoflurane by the foetal lamb in utero: Effect on regional blood flow. Can Anaesth Soc J 30:581, 1983PubMedCrossRefGoogle Scholar
  16. 16.
    Baraka A: Correlation between maternal and foetal PO2 and PCO2 during cesarean delivery. Brit J Anaesth 42:434, 1972Google Scholar
  17. 17.
    Levinsohn GL, Shnider SM, deLorimier AA et al: Effects of maternal hyperventilation on uterine blood flow and fetal oxygenation and acid-base status. Anesthesiology 40:340, 1974CrossRefGoogle Scholar
  18. 18.
    Geber WF, Schramm LC: Congenital malformations of the central nervous system produced by narcotic analgesics in the hamster. Am J Obstet Gynecol 123:705, 1975PubMedGoogle Scholar
  19. 19.
    Fujinaga M, Mazze RI, Jackson EC et al: Reproductive and teratogenic effects of sufentanil and alfentanil in Sprague-Dawley rats. Anesthesiology 67:166, 1988Google Scholar
  20. 20.
    Safra MJ, Oakley GP: Association between cleft lip with and without cleft palate and prenatal exposure to diazepam. Lancet ii:478, 1975CrossRefGoogle Scholar
  21. 21.
    Rosenberg L, Mitchell AA, Parsells JL et al: Lack of relation of oral clefts to diazepam use during pregnancy. N Engl J Med 309:1282, 1983PubMedCrossRefGoogle Scholar
  22. 22.
    Galloon S: Ketamine for obstetric delivery. Anesthesiology 44:522, 1976PubMedCrossRefGoogle Scholar
  23. 23.
    Ralston DH, Shnider SM, deLorimier AA: Effects of equipotent metaraminol, mephenteramine and methoxamine on uterine blood flow in the pregnant ewe. Anesthesiology 40:354, 1974PubMedCrossRefGoogle Scholar
  24. 24.
    Ramanathan S, Friedman S, Moss P et al: Phenylephrine for the treatment of maternal hypotension due to epidural anesthesia. Anesth Analg 63(5):262, 1984Google Scholar
  25. 25.
    Fujinaga M, Mazze RI: Reproductive and teratogenic effects of lidocaine in Sprague Dawley rats. Anesthesiology 65:626, 1986PubMedCrossRefGoogle Scholar
  26. 26.
    Naulty JS, Cefalo RC, Lewis PE: Fetal toxicity of nitroprusside in the pregnant ewe. Am J Obstet Gynecol 139:708, 1981PubMedGoogle Scholar
  27. 27.
    Kofke WA, Wuest HP, McGinnis CA: Cesarean section following ruptured cerebral aneurysm and neuroresuscitation. Anesthesiology 60:242, 1984PubMedCrossRefGoogle Scholar
  28. 28.
    Rigg D, McDonogh A: Use of sodium nitroprusside for deliberate hypotension during pregnancy. Brit J Anaesth 53:985, 1981CrossRefGoogle Scholar
  29. 29.
    Neuman B, Lam AM: Induced hypotension for clipping of a cerebral aneurysm during pregnancy: A case report and brief review. Anesth Analg 65:675, 1986CrossRefGoogle Scholar
  30. 30.
    Eisenach JC: Maternally administered labetalol produces less adrenergic blockade in fetus than in mother. Anesthesiology 71:A915, 1989CrossRefGoogle Scholar
  31. 31.
    MacPherson M, Broughton Pipkin F, Rutter N: The effect of maternal labetalol in the newborn infant. Br J Obstet Gynecol 93:539, 1986CrossRefGoogle Scholar
  32. 32.
    Eisenach JC, Castro MI: Maternally administered esmolol produces fetal beta adrenergic blockade and hypoxemia. Anesthesiology 71:718, 1989PubMedCrossRefGoogle Scholar
  33. 33.
    Shankar KB, Moseley H, Kumar Y et al: Arterial to end-tidal carbon dioxide tension difference during Caesarean section. Anaesthesia 41:698,1986PubMedCrossRefGoogle Scholar
  34. 34.
    Woods JR, Plessinger MA, Clark KE: Effect of cocaine on uterine blood flow and fetal oxygenation. JAMA 257:957, 1987PubMedCrossRefGoogle Scholar
  35. 35.
    Palahniuk RJ, Shnider SM, Eger EL II: Pregnancy decreases the requirements of inhaled anesthetic agents. Anesthesiology 41:82, 1974PubMedCrossRefGoogle Scholar
  36. 36.
    Datta S, Lambert DH, Gregus J et al: Differential sensitivity of mammalian nerve fibers during pregnancy. Anesth Analg 62:1070, 1983PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1995

Authors and Affiliations

  • A. M. Malinow
  • J. W. Ostheimer

There are no affiliations available

Personalised recommendations