{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T12:49:23Z","timestamp":1788094163474,"version":"build-2803163510"},"reference-count":29,"publisher":"S. Karger AG","issue":"11","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Fetal Diagn Ther"],"published-print":{"date-parts":[[2020]]},"abstract":"<b><i>Introduction:<\/i><\/b> Open fetal repair of myelomeningocele (MMC) is an option for prenatally diagnosed spina bifida. Historically, high-dose volatile anesthetic was used for uterine relaxation but is associated with fetal cardiovascular depression. We examined the impact of administering a supplemental remifentanil infusion on the concentration of inhaled anesthetic required for intraoperative uterine relaxation. <b><i>Methods:<\/i><\/b> We retrospectively analyzed 22 consecutive patients who underwent open fetal MMC repair with desflurane anesthesia from 2014 to 2018. The anesthetic protocol was modified to include high-dose opioid with remifentanil in 2016. We examined intraoperative end-tidal desflurane concentrations, vasopressor use, incidence of umbilical artery Doppler abnormalities, and incidence of preterm labor and delivery. <b><i>Results:<\/i><\/b> Patients (<i>n<\/i> = 11) who received desflurane and remifentanil (Des\/Remi) were compared to patients (<i>n<\/i> = 11) who received desflurane (Des) alone. Intraoperatively, the maximum end-tidal desflurane required to maintain uterine relaxation was lower in the Des\/Remi group (7.9 \u00b1 2.2% vs. 13.1 \u00b1 1.2%, <i>p<\/i> &#x3c; 0.001). The mean phenylephrine infusion rate was also lower in the Des\/Remi group (36 \u00b1 14 vs. 53 \u00b1 10 mcg\/min, <i>p<\/i> = 0.004). <b><i>Discussion:<\/i><\/b> Use of opioid with supplemental remifentanil was associated with lower volatile anesthetic dosing and decreased vasopressor use; fetal outcomes were not different. Remifentanil may allow for less volatile anesthetic use while maintaining adequate uterine relaxation. <\/jats:p>","DOI":"10.1159\/000509384","type":"journal-article","created":{"date-parts":[[2020,9,10]],"date-time":"2020-09-10T21:00:35Z","timestamp":1599771635000},"page":"810-816","source":"Crossref","is-referenced-by-count":19,"title":["Use of Remifentanil for Open in utero Fetal Myelomeningocele Repair Maintains Uterine Relaxation with Reduced Volatile Anesthetic Concentration"],"prefix":"10.1159","volume":"47","author":[{"given":"Benjamin J.","family":"Marsh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jina","family":"Sinskey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth L.","family":"Whitlock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marla B.","family":"Ferschl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Rollins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2020,9,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ogx.0000268628.82123.90"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014379"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2017.08.004"},{"key":"ref4"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03350.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31828ea597"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159\/000477963"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1097\/01.anes.0000265155.01815.6d"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159\/000364863"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(94)90457-x"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e318283c954"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1177\/0310057x0803600609"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199807000-00017"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejphar.2012.09.045"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001072"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/anae.14080"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg132"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111\/pan.13185"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1177\/0883073817691696"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9592.2010.03506.x"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000156566.62182.AB"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199806000-00008"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2017.00011"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.2147\/lra.s143618"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199710000-00061"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e3181c03e0c"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h846"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000000077"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1980.138"}],"container-title":["Fetal Diagnosis and Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/509384","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/509384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:46:37Z","timestamp":1745423197000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000509384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":29,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,10,22]]},"published-print":{"date-parts":[[2020,10,27]]}},"URL":"https:\/\/doi.org\/10.1159\/000509384","archive":["Portico"],"relation":{},"ISSN":["1015-3837","1421-9964"],"issn-type":[{"value":"1015-3837","type":"print"},{"value":"1421-9964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}