Department of Anaesthesiology, Duke University Medical Center, Box 3094, Durham, NC, USA.
Br J Anaesth. 2011 Jun;106(6):851-5. doi: 10.1093/bja/aer097. Epub 2011 Apr 29.
Remifentanil undergoes extensive placental transfer and has been used to provide fetal immobilization and anaesthesia for in utero fetal endoscopic interventions. We report three cases of the ex utero intrapartum treatment performed under neuraxial anaesthesia where the maternal administration of remifentanil was used to provide fetal immobilization and analgesia. Fetal pathology included goiter and arthrogryposis, with one case requiring a tracheostomy. The longest time on placental circulation was 21 min. No clinically significant maternal sedation or respiratory depression was observed. In all cases, remifentanil provided adequate fetal immobilization and obviated the need to administer other analgesics or neuromuscular blocking agents. Remifentanil is a useful adjunct for ex utero fetal procedures.
瑞芬太尼在胎盘内广泛转移，并已被用于为宫内胎儿内镜介入提供胎儿固定和麻醉。我们报告了三例在椎管内麻醉下进行的子宫外分娩期治疗病例，其中使用了瑞芬太尼来提供胎儿固定和镇痛。胎儿病理学包括甲状腺肿和关节挛缩，其中一例需要进行气管切开术。胎盘循环的最长时间为 21 分钟。未观察到有临床意义的母体镇静或呼吸抑制。在所有情况下，瑞芬太尼都提供了足够的胎儿固定，并避免了需要使用其他镇痛药或神经肌肉阻滞剂。瑞芬太尼是子宫外胎儿手术的有用辅助手段。
