Anesthesia for cadaveric renal transplantation
Sawa, T.; Hirata, T.; Yamada, E.; Hosokawa, T.; Mitsufuji, T.; Yoda, K.; Miyazaki, M.
Masui. Japanese Journal of Anesthesiology 36(11): 1766-1771
1987
ISSN/ISBN: 0021-4892 PMID: 3328792 Document Number: 287753
Twenty-four patients received anesthesia for cadaveric renal transplantation in authors' institution in the past 10 years, and the method of anesthesia especially the way to use muscle relaxants were evaluated. The cadaveric renal transplantation offers several difficulties such as essentially emergency nature of anesthesia, unprepared conditions of the subjects, and anuria of not only preoperative but also intra- and postoperative periods. The choice of anesthetics, especially the selection of muscle relaxant is particularly important. In this study, 22 cases were given succinylcholine chloride (SCC) and 2 cases were given vecuronium. Types of anesthetics has no significant meaning in the cases of cadaveric renal transplantation. The overdose of SCC infusion occasionally caused prolonged apnea, and its bolus injection precipitated transient sinus arrest in patients with hyperkalemia during induction. The study suggests that the intravenous drip of SCC is a safe method and its maximum dose is 600 mg, which is roughly 35 .mu.g/kg/min. Vecuronium gives stable muscle relaxation and prompt recovery is noted with termination of the drug. Although SCC drip is a very useful method at present, vecuronium will be used as muscle relaxant for the anesthesia of cadaveric renal transplantation.