Hemodynamic management with norepinephrine and BIS-guided TCI sedation during fetoscopy for twin-to-twin transfusion syndrome
DOI:
https://doi.org/10.65003/9g8bm183Keywords:
Fetoscopy; Twin-to-twin transfusion syndrome; TCI sedation; BIS monitoring; Norepinephrine; Obstetric anesthesiaAbstract
Twin-to-twin transfusion syndrome (TTTS) is a serious complication of monochorionic diamniotic pregnancies. Fetoscopic laser photocoagulation currently represents the treatment of choice, although anesthetic management remains challenging because of the need to preserve maternal hemodynamic stability and adequate uteroplacental perfusion. We present the case of a pregnant patient who underwent fetoscopy under subarachnoid anesthesia, sedation with propofol administered by target-controlled infusion (TCI) guided by the bispectral index (BIS), and prophylactic support with a continuous norepinephrine infusion. The patient remained hemodynamically stable throughout the procedure, with no episodes of hypotension or maternal-fetal complications.
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Copyright (c) 2026 Constanza Lepori, Juan Pedro Pennacchioni , Melina Machado, Renata Rossi (Autor/a)
This work is licensed under a Creative Commons Attribution 4.0 International License.
