Chapter 28 - Anesthesia and analgesia in the fetus and neonate

Abstract

Increasing attention is currently being given to fetal and neonatal anesthesia and analgesia by members of the medical and veterinary professions and animal research community. While interventions are rarely carried out on the fetus prior to labor in veterinary clinical practice, the use of invasive surgical procedures in animal models has been an integral part of fetal and neonatal research for many decades. Due to a similar degree of neurologic maturation at birth, sheep and nonhuman primates are commonly used to advance the clinical management of human infants before, during and after birth and to refine surgical techniques and therapies for in utero procedures in human fetuses. While large animal species represent the majority of the published maternal:fetal surgical models, intracranial injection and electroporation of fetuses is increasingly used for gene transfer during surgical exposure of the gravid uterus and has been described in rodents and ferrets. This chapter is intended for use by investigative groups, veterinarians, and animal care professionals utilizing these animal models in the research setting. It reviews current literature and highlights key concepts related to the use of anesthetics and analgesics in the pregnant dam, the fetus and the newborn, including considerations and rationale for drug selection and supportive care.