Department of Anesthesiology and Critical Care

Description of Research Expertise

I am interested in anesthesia for fetal surgery. Some fetuses have developmental problems which can cause death in the middle of gestation unless corrected. Other disease processes will not cause death in utero but will interfere with successful transition to extrauterine life. This is a relatively new field, and much of anesthesia practice is based on translation of knowlege from other fields and similar (but not identical) patient populations. Much remains to be studied, characterized, and optimized to ensure optimal results for both the fetus and the mother.
One upcoming project involves quantifying the fetal exposure to volatile anesthetic agents. The fetus must be anesthetized for thoracic surgery to prevent neurohormonal stress responses, which have been associated with poorer outcome in similar situations in neonates. The anesthetic agents must be given to the mother to breath and then transferred across her placenta to get to the fetus. We do not really know mow much anesthetic the fetus is exposed to, and if it is enough.
Another project involves determining the best sedation regimen for mothers with twins who have unbalanced blood flow from the placenta. This unequal blood flow can result in large size and weight discrepancies and even cause severe growth restriction and heart failure. Both twins are at risk for death, and endoscopic laser surgery can help correct the blood flow problems. Anesthesia can be done for this procedure in a variety of ways, and we plan on conducting a trial to compare the different anesthetic regimens to maximize maternal safety and optimize operating conditions.