{Reference Type}: Case Reports
{Title}: Avoiding the Use of Halogenated Anesthetic Agents for Uterine Relaxation in Open Mid-Gestation Fetal Surgery: A Case Report.
{Author}: Hoagland MA;Fleming J;Foley C;Fernandez P;Wood CL;Hoagland MA;Fleming J;Foley C;Fernandez P;Wood CL;
{Journal}: Fetal Diagn Ther
{Volume}: 49
{Issue}: 4
{Year}: 2022
{Factor}: 2.208
{DOI}: 10.1159/000524899
{Abstract}: <B>BACKGROUND: </B>Profound uterine relaxation is required for open fetal surgery. This is typically achieved by the administration of high-dose halogenated anesthetic agents. However, this anesthetic technique is associated with adverse cardiovascular effects in the fetus and may have long-term neurocognitive effects as well.<BR><B>METHODS: </B>We pre-sent reports for 2 patients in whom uterine relaxation was maintained with nitroglycerin and magnesium infusions without any exposure to halogenated anesthetic agents. There were no adverse fetal or maternal effects from this technique.<BR><B>CONCLUSIONS: </B>To the best of our knowledge, these are the first reports of open fetal surgery being performed without the use of halogenated anesthetic agents. This has potential short- and long-term benefits for the fetus, particularly as more complex and longer duration minimally invasive procedures are developed.