Perioperative And Research Anesthesia Management In40Patients Undergoing Allogenic Renal Transplantation

Background:Results of blood and blood glucose in patients undergoing allogenic renal transplantation show that changes of Na+, Cl-, hematocrit(Hct), hemoglobin(HGB) may be related to the blood dilution.Objective:The anaesthetic information of40cases who received renal transplantation in jiuling hospital were retrospectively analyzed and researched,which inciuded changes of haemodynamics, electrolytes, changes of serum biochemical index.To comprehend the application of general anesthesia in kidney transplantation.To explore the effects of different anesthesia regimens for kidney transplant patients, and to get the key points of anesthesia management. To investigate an ideal anesthesia management in patients undergoing allogenic renal transplantation.Methods:Anesthesic information of40patients in jiuling hospital who received renal transplantation from January2009to March2010were collected and analyzed. Mean arterial blood pressure (MAP), central venous pressure (CVP) and heart rate (HR), electrolytes,glucose,blood gas analysis were monitored and analyzed in the40patients undergoing renal transplantation before anesthesia(T1), before opening of renal artery(T2),10minutes after opening renal artery(T3) and at the end of the surgery(T4).Results:1. All the40patients,who received the allograft renal transplantation,were attended the test all over our test.2. The vital signs of the40patients wers very stable.Compared with before anesthesia(T1), the change of heart rate was no significant difference(P>0.05);CVP, MAP, pH, HCO3-and BE were decreased significantly(P<0.05).3. K+and glucose levels increased significantly (P<0.01) at10minutes after opening of renal artery. Compared with before opening of renal artery, pressure of CO2and02were no significantly increased at10minutes after opening of renal artery (P>0.05).4. Hemodynamics parameters changed in the different surgery phase.5. The common perioperative complications are hypertension in recovery stage,restlessness in recovery stage, post-anesthesia recovery delay and perioperative pulmonary edema,and so on.Conclusion:1. Renal transplantation patients always have complex pre-operative condition and the general conditions were poor,so hemodialysis should be actively taken before surgery to correct anemia and environmental disorder,and to control the hypertension and infection,then improve patient’s tolerance to anaesthesia and operation.2. Perioperative management should include perioperative circulation, respiratory, water-electrolyte balance, maintaining of the suitable temperature.3. These findings suggest that a key to successful general anesthesia of renal transplantation involves sufficient preoperative preparation, rational anesthetic drug selection and the maintenance of perioperative circulation, breathing, and water-electrolyte and acid-base balance.4. The common perioperative complications are hypertension in recovery stage, restlessness in recovery stage, post-anesthesia recovery delay and perioperative pulmonary edema, it has great significance for patient’s security to actively prevent and deal with these anesthesia complications of renal transplantation patients during perioperative period.