FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2007657446> ?p ?o ?g. }

• W2007657446 endingPage "S169" @default.
• W2007657446 startingPage "S169" @default.
• W2007657446 abstract "ObjectiveMost fetoscopies are performed under (loco)regional anesthesia, which does not provide fetal immobilization. Transplacental administration of sedatives may achieve this and comfort the mother. Diazepam (DZP) induces profound maternal sedation and incomplete fetal immobilization. We compared the efficacy of I.V. remifentanil (REMI), a short acting opioid (umbilical vein/maternal artery ratio 0.88) to that of DZP for maternal sedation and fetal immobilization.Study designSingle center randomized double blind trial with 54 consecutive women undergoing fetoscopic cord occlusion (n = 12) or laser surgery for TTTS (n = 42). Following CSE-anesthesia, incremental doses DZP (bolus 5 mg, 5 mg 10 min later and 2.5 mg top ups) or continuous infusion REMI (0.1 μg/kg/min followed by 0.025 bolus top ups). Patients, gynecologists and attending anesthesiologist were blinded to the sedative used. Maternal sedation (observer alertness score-OAS, need for additional medication), hemodynamics, side-effects as well as fetal hemodynamics and immobilization (Visual Analog Score by ultrasonographer and surgeon, later review of videotape by third assessor) were evaluated prior, during and for 60 min after surgery. Statistics were by ANOVA testing, and chi-square Fisher exact test for categorical data. Data are presented as mean ± Standard Deviation, median and interquartile range and percentage of group total.ResultsFour fetuses were excluded because of absence of fetal movements at baseline. DZP (mean = 14.5 ± 4.8 mg) resulted in deeper maternal sedation without respiratory depression. REMI (0.115 ± 0.020 μg/kg/min) produced adequate maternal sedation with mild but clinically irrelevant respiratory depression, except in one patient with OAS <4. Fetal immobilizatin occurred faster and was better but on stimulation the fetus was easily awakened. This resulted in more often good surgical conditions (32 % DZP, 92 % REMI), shorter operation times and mothers being less sedated afterwards. Similar doses and number of top ups of ephedrine and phenylephrine were required in both groups.ConclusionREMI provides excellent fetal immobilization and maternal sedation and is immediately reversible. This method of transplacental sedation could also be applied during other fetal procedures without direct fetal pain stimulus (eg MRI). ObjectiveMost fetoscopies are performed under (loco)regional anesthesia, which does not provide fetal immobilization. Transplacental administration of sedatives may achieve this and comfort the mother. Diazepam (DZP) induces profound maternal sedation and incomplete fetal immobilization. We compared the efficacy of I.V. remifentanil (REMI), a short acting opioid (umbilical vein/maternal artery ratio 0.88) to that of DZP for maternal sedation and fetal immobilization. Most fetoscopies are performed under (loco)regional anesthesia, which does not provide fetal immobilization. Transplacental administration of sedatives may achieve this and comfort the mother. Diazepam (DZP) induces profound maternal sedation and incomplete fetal immobilization. We compared the efficacy of I.V. remifentanil (REMI), a short acting opioid (umbilical vein/maternal artery ratio 0.88) to that of DZP for maternal sedation and fetal immobilization. Study designSingle center randomized double blind trial with 54 consecutive women undergoing fetoscopic cord occlusion (n = 12) or laser surgery for TTTS (n = 42). Following CSE-anesthesia, incremental doses DZP (bolus 5 mg, 5 mg 10 min later and 2.5 mg top ups) or continuous infusion REMI (0.1 μg/kg/min followed by 0.025 bolus top ups). Patients, gynecologists and attending anesthesiologist were blinded to the sedative used. Maternal sedation (observer alertness score-OAS, need for additional medication), hemodynamics, side-effects as well as fetal hemodynamics and immobilization (Visual Analog Score by ultrasonographer and surgeon, later review of videotape by third assessor) were evaluated prior, during and for 60 min after surgery. Statistics were by ANOVA testing, and chi-square Fisher exact test for categorical data. Data are presented as mean ± Standard Deviation, median and interquartile range and percentage of group total. Single center randomized double blind trial with 54 consecutive women undergoing fetoscopic cord occlusion (n = 12) or laser surgery for TTTS (n = 42). Following CSE-anesthesia, incremental doses DZP (bolus 5 mg, 5 mg 10 min later and 2.5 mg top ups) or continuous infusion REMI (0.1 μg/kg/min followed by 0.025 bolus top ups). Patients, gynecologists and attending anesthesiologist were blinded to the sedative used. Maternal sedation (observer alertness score-OAS, need for additional medication), hemodynamics, side-effects as well as fetal hemodynamics and immobilization (Visual Analog Score by ultrasonographer and surgeon, later review of videotape by third assessor) were evaluated prior, during and for 60 min after surgery. Statistics were by ANOVA testing, and chi-square Fisher exact test for categorical data. Data are presented as mean ± Standard Deviation, median and interquartile range and percentage of group total. ResultsFour fetuses were excluded because of absence of fetal movements at baseline. DZP (mean = 14.5 ± 4.8 mg) resulted in deeper maternal sedation without respiratory depression. REMI (0.115 ± 0.020 μg/kg/min) produced adequate maternal sedation with mild but clinically irrelevant respiratory depression, except in one patient with OAS <4. Fetal immobilizatin occurred faster and was better but on stimulation the fetus was easily awakened. This resulted in more often good surgical conditions (32 % DZP, 92 % REMI), shorter operation times and mothers being less sedated afterwards. Similar doses and number of top ups of ephedrine and phenylephrine were required in both groups. Four fetuses were excluded because of absence of fetal movements at baseline. DZP (mean = 14.5 ± 4.8 mg) resulted in deeper maternal sedation without respiratory depression. REMI (0.115 ± 0.020 μg/kg/min) produced adequate maternal sedation with mild but clinically irrelevant respiratory depression, except in one patient with OAS <4. Fetal immobilizatin occurred faster and was better but on stimulation the fetus was easily awakened. This resulted in more often good surgical conditions (32 % DZP, 92 % REMI), shorter operation times and mothers being less sedated afterwards. Similar doses and number of top ups of ephedrine and phenylephrine were required in both groups. ConclusionREMI provides excellent fetal immobilization and maternal sedation and is immediately reversible. This method of transplacental sedation could also be applied during other fetal procedures without direct fetal pain stimulus (eg MRI). REMI provides excellent fetal immobilization and maternal sedation and is immediately reversible. This method of transplacental sedation could also be applied during other fetal procedures without direct fetal pain stimulus (eg MRI)." @default.
• W2007657446 created "2016-06-24" @default.
• W2007657446 creator A5007739415 @default.
• W2007657446 creator A5018476377 @default.
• W2007657446 creator A5020433879 @default.
• W2007657446 creator A5026814708 @default.
• W2007657446 creator A5027675035 @default.
• W2007657446 creator A5075515817 @default.
• W2007657446 creator A5079918230 @default.
• W2007657446 creator A5081192617 @default.
• W2007657446 creator A5091409871 @default.
• W2007657446 date "2004-12-01" @default.
• W2007657446 modified "2023-09-24" @default.
• W2007657446 title "Randomized double blind comparison of remifentanil and diazepam for fetal immobilization and maternal sedation during fetoscopic surgery" @default.
• W2007657446 doi "https://doi.org/10.1016/j.ajog.2004.10.502" @default.
• W2007657446 hasPublicationYear "2004" @default.
• W2007657446 type Work @default.
• W2007657446 sameAs 2007657446 @default.
• W2007657446 citedByCount "1" @default.
• W2007657446 countsByYear W20076574462022 @default.
• W2007657446 crossrefType "journal-article" @default.
• W2007657446 hasAuthorship W2007657446A5007739415 @default.
• W2007657446 hasAuthorship W2007657446A5018476377 @default.
• W2007657446 hasAuthorship W2007657446A5020433879 @default.
• W2007657446 hasAuthorship W2007657446A5026814708 @default.
• W2007657446 hasAuthorship W2007657446A5027675035 @default.
• W2007657446 hasAuthorship W2007657446A5075515817 @default.
• W2007657446 hasAuthorship W2007657446A5079918230 @default.
• W2007657446 hasAuthorship W2007657446A5081192617 @default.
• W2007657446 hasAuthorship W2007657446A5091409871 @default.
• W2007657446 hasConcept C141071460 @default.
• W2007657446 hasConcept C168563851 @default.
• W2007657446 hasConcept C2776175493 @default.
• W2007657446 hasConcept C2776277131 @default.
• W2007657446 hasConcept C2776814716 @default.
• W2007657446 hasConcept C2778891214 @default.
• W2007657446 hasConcept C42219234 @default.
• W2007657446 hasConcept C71924100 @default.
• W2007657446 hasConceptScore W2007657446C141071460 @default.
• W2007657446 hasConceptScore W2007657446C168563851 @default.
• W2007657446 hasConceptScore W2007657446C2776175493 @default.
• W2007657446 hasConceptScore W2007657446C2776277131 @default.
• W2007657446 hasConceptScore W2007657446C2776814716 @default.
• W2007657446 hasConceptScore W2007657446C2778891214 @default.
• W2007657446 hasConceptScore W2007657446C42219234 @default.
• W2007657446 hasConceptScore W2007657446C71924100 @default.
• W2007657446 hasIssue "6" @default.
• W2007657446 hasLocation W20076574461 @default.
• W2007657446 hasOpenAccess W2007657446 @default.
• W2007657446 hasPrimaryLocation W20076574461 @default.
• W2007657446 hasRelatedWork W1755616823 @default.
• W2007657446 hasRelatedWork W1975097303 @default.
• W2007657446 hasRelatedWork W1993678291 @default.
• W2007657446 hasRelatedWork W1998838280 @default.
• W2007657446 hasRelatedWork W2034242176 @default.
• W2007657446 hasRelatedWork W2077693656 @default.
• W2007657446 hasRelatedWork W2124545707 @default.
• W2007657446 hasRelatedWork W2350246059 @default.
• W2007657446 hasRelatedWork W2351450935 @default.
• W2007657446 hasRelatedWork W3024164711 @default.
• W2007657446 hasVolume "191" @default.
• W2007657446 isParatext "false" @default.
• W2007657446 isRetracted "false" @default.
• W2007657446 magId "2007657446" @default.
• W2007657446 workType "article" @default.