General vs local anesthesia for the percutaneous laser treatment of twin-twin transfusion syndrome

A. Cristina Rossi, Marc A. Kaufman, Patricia W. Bornick, Rubén A. Quintero

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Objective: The purpose of this study was to review our anesthetic experience in selective laser photocoagulation of communicating vessels (SLPCV) to treat twin-twin transfusion syndrome (TTTS). Study Design: A total of 266 consecutive eligible patients were studied. Twenty-seven patients (10%) underwent general anesthesia (GenA), 100 (38%) received total intravenous anesthesia (TIVA), and 139 (52%) received local anesthesia/conscious sedation (LocA). Maternal-fetal hemodynamic fluctuations were compared between groups. Results: Maternal blood pressure decreased significantly in all 3 groups during surgery (P < .0001) but was more evident in the GenA and TIVA groups (P < .0001). Maternal heart rate varied significantly in GenA (P = .02) but was constant in LocA and TIVA. There were no significant differences in fetal heart rate changes between the groups. Intraamniotic bleeding occurred more frequently with GenA and TIVA than LocA(P < .0001). Conclusion: Local anesthesia is the safest anesthetic technique for SLPCV in TTTS patients.

Original languageEnglish
JournalAmerican Journal of Obstetrics and Gynecology
Volume199
Issue number2
DOIs
StatePublished - Aug 1 2008

Fingerprint

Fetofetal Transfusion
Intravenous Anesthesia
Local Anesthesia
Conscious Sedation
General Anesthesia
Lasers
Light Coagulation
Mothers
Anesthetics
Fetal Heart Rate
Therapeutics
Heart Rate
Hemodynamics
Hemorrhage
Blood Pressure

Keywords

  • fetal outcome
  • general anesthesia
  • local anesthesia/conscious sedation
  • maternal outcome
  • twin-twin transfusion syndrome

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

General vs local anesthesia for the percutaneous laser treatment of twin-twin transfusion syndrome. / Rossi, A. Cristina; Kaufman, Marc A.; Bornick, Patricia W.; Quintero, Rubén A.

In: American Journal of Obstetrics and Gynecology, Vol. 199, No. 2, 01.08.2008.

Research output: Contribution to journalArticle

Rossi, A. Cristina ; Kaufman, Marc A. ; Bornick, Patricia W. ; Quintero, Rubén A. / General vs local anesthesia for the percutaneous laser treatment of twin-twin transfusion syndrome. In: American Journal of Obstetrics and Gynecology. 2008 ; Vol. 199, No. 2.
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