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Int J Obstet Anesth · Apr 2013
Case ReportsAn ex utero intrapartum treatment procedure in a patient with a family history of malignant hyperthermia.
- I S Hofer, B Mahoney, A Rebarber, and Y Beilin.
- Department of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USA. Ira.hofer@mountsinai.org
- Int J Obstet Anesth. 2013 Apr 1;22(2):146-8.
AbstractIn the EXIT (ex utero intrapartum treatment) procedure, after uterine incision, uterine relaxation is maintained to prevent placental separation and the fetus is supported via the placenta until the airway is successfully established. The traditional method to maintain uterine relaxation is with the use of high-dose potent inhaled anesthetics during general anesthesia. A patient with a family history of malignant hyperthermia required an EXIT procedure. The history of malignant hyperthermia precluded the use of potent inhaled anesthetics and an alternate plan using propofol and remifentanil infusions for anesthesia and nitroglycerin 16 μg/kg/min for uterine relaxation allowed for good surgical conditions. The presence of malignant hyperthermia required an alternate plan and close collaboration in order to ensure good patient outcome.Copyright © 2013 Elsevier Ltd. All rights reserved.
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