Anaesthesia for fetal surgery

Abstract

A variety of fetal disorders are now accessible to treatment in utero due to the rapid advances in diagnostic and therapeutic possibilities. Different surgical techniques, such as open or endoscopic fetal procedures, require special anaesthesiological management because the anaesthesiologist has to care for two patients—the mother and the fetus. This chapter describes currently performed fetal interventions and outlines anaesthesiological features. We describe the pros and cons of regional and general anaesthesia for this highly specialized surgical field, as well as different treatment modalities in post-operative pain and tocolytic therapy. Ethical issues arise because fetal surgery is a relatively new sector and deals with unborn life. Although, currently, only a few centres carry out fetal surgical interventions, this medical field is expanding. This chapter offers some support to the anaesthesiologists who have to care for these patients in the future.