Anesthesia for the EXIT Procedure

The EXIT procedure is a rare procedure typically performed for neonatal airway management, but is occasionally performed for other indications. Maternal and neonatal risks to the procedure are significant, and should only be performed at centers with experience and backup maternal and fetal resources. Adequate uterine relaxation is paramount to successful completion of the procedure, which is typically achieved with volatile anesthetic agents and/or nitroglycerin. While significant surgical hemorrhage is a theoretical possibility, when performed in experienced centers this complication is rare. Successful procedures rely on a multidisciplinary approach with meticulous planning and excellent communication throughout the perioperative period. The incidence of EXIT procedures is likely to increase in the future as prenatal diagnosis and ultrasound technology improve.