| Objective:To compare the effects of volatile induction and maintenance anesthesia(VIMA), total intravenous anesthesia(TIVA) and continue epidural anesthesia(CEA) on renal function in patients undergoing kiddney transplantation.Methods:Sixty patients were assessed as ASA III or IV, aged20-45yr, weighing45-75kg and taken kidney transplantation were studied. They were randomly divided into three groups (n=20):group V (VIMA, inhalational anesthetics sevoflurane for maintenance of general anesthesia), group T (TIVA, intravenous anesthetics propofol for maintenance of general anesthesia) and group C (CEA, performed at interspace L1-2and0.75%ropivacaine was given intermittently). Some parameters of MAP、HR and CVP the total volume of fluid infusion, the dosage of vasoactive drugs and even the time of anesthesia were recorded. Venous blood samples were obtained to detect the serum concentrations of Cr (Creatinine)、BUN (Blood urea nitrogen)、cystsin C (CysC) and β2microglobulin(β2-MG) at different time points:before renal vascular anastomotic opening (TO) and1st (T1)、2nd (T2)、3rd (T3)、4th (T4)、5th (T5)、6th (T6) and7th (T7) day after the kidney reperfusion. Meanwhile, urine volume and the consumption of furosenide administration during the7ds were recorded.Results:There were no significant difference among the three groups in basic informations of the patients, MAP、HR and CVP before transplanted renal artery opening, volumes of intraoperatively infused fluid and vasoactive drugs to maintain MAP and HR at preoperative baseline level, durations of operation and anesthesia, urine volumes and consumptions of furosemide after the operation(P>0.05). Serum concentrations of Cr、 BUN. Cys C、β2-MG decreased after kidney transplantation (P<0.05), while, there was no significant difference among the three groups (P>0.05).Conclusion:There are no significant differences in the effect of VIMA、TIVA and CEA on renal function. These three methods are all safe for patients undergoing kidney transplantation. |
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