Comparative Study Of Different Anesthesia Methods In Patients Received Renal Transplantation Under The Direction Of Bispectral Index

Objective: To compare the effect of general anesthesia , epidural block combined general anesthesia and transversus abdominis plane block combined general anesthesia in patients received renal transplantation under the direction of bispectral index.And to observe the hemodynamic changes,the condition during operation,the impacts of early graft function and the advantage of BIS.Metheds: Sixty patients taken kidney transplantion were assessed as ASA ???,aged 18?50yr,(35.6±7.4 )yr,weighing 45?70kg .They were randomly divided into three groups(n=20):? group (pure general anesthesia with BIS); II group (general anesthesia and epidural block with BIS );? group (transversus abdominis Plane block combined general anesthesia).? group were TCI propofol during anesthesia induction under the direction of BIS. ? group were performed at interspace L1-2 and 2% lidocaine was given ,and then TCI propofol during anesthesia induction,during the operation 0.375%ropivacine was given intermittently. ? group were in the ultrasound guided transversus abdominis Plane block with 0.5% ropivacaine 1.5mg/kg in one side under the direction of BIS, and then TCI propofol during anesthesia induction.The parameters of MAP?HR?CVP were monitored at entering the operation room(T0),before anesthesia intubation(T1),3 minutes after anesthesia induction(T2),at intubation (T3),3 minutes after intubation(T4),before opening of renal artery (T5),10 minutes after opening renal artery(T6). And even the time of ansthesia and operation,the recovery time ,quality of recovery from anesthesia were also recorded.Blood samples were obtained to detect the serm concentrations of Cr(Creatinine)?BUN(Blood urea nitrogen)?urinary volume at different time Points :before renal transplantation and 7 days after the kidney reperfusion.Results: 1 .There were no significant difference among the three groups in basic informations of patients ,durations of operation and anesthesia (P>0.05).2.There were no significant difference among the three groups at the TO time.In ? with T0( group ,the changes of nemodynamics decreased significantly at T1 time compared P<0.05 ) .There were no significant difference among the three groups at any time (P>0.05) .And after prenal artery (T6),the MAP and CVP decreased significantly and HR increased compared in three groups.The II group and ? group awaken with the shorter time ,the less consumption of anesthetics,the better quality of recovery from anesthesia (P< 0.05) .3. Serum concentrations Cr?BUN decreased after kidney transplantation in a week (P<0.05).4. Urinary volume increased after kidney transplantation (P<0.05 ) ,while there was no significant differences among the three groups (P>0.05) .Conclusion : These three methods are all safe for patients undergoing renal transplantation. But transversus abdominis plane block combined general anesthesia and epidural block combined general anesthesia with BIS in patients can reduce the consumption of anesthetics, awaken with shorter time and have the higher quality of recovery.There are no significant differences in the effect of three groups on renal transplantation.