Anaesthetic experience of 200 renal transplantation cases: A retrospective study

Yıl 2016, Cilt: 5 Sayı: 2, 118 - 126, 01.05.2016

İlker İnce Ali Ahıkalıoğlu Mehmet Aksoy Dostbil Ayşenur Mine Çelik Nazım Doğan Mehmet Çömez Bülent Aydınlı

https://doi.org/10.5505/abantmedj.2016.08831

Öz

INTRODUCTION: Renal transplantation is the best method of treatment for end-stage renal disease. Anaesthetic management should be well-planned during preoperative, intraoperative and postoperative period. Several studies have done for renal transplantation anaesthesia. Some studies have investigated the anaesthesia technique, some of them investigated effect of anaesthetic drugs on patients and transplanted kidneys etc. In this study, we aimed to compare our results with literature and to present our experience of anaesthetic management in 200 renal transplantation patients. METHODS: We used the patients’ files for obtaining the data. RESULTS: We used intravenous anaesthetics which were propofol 2 mg/kg , fentanyl 2-3 µgr/kg and atracurium 0.6 mg/kg or rocuronium 0.6 mg/kg were used as muscle relaxants for the induction. During anaesthesia, 1-2% isoflurane n: 67 , 1-2% sevoflurane n: 49 or 6-7% desflurane n: 79 was used for maintenance of the anaesthesia.Remifentanil infusion 0.25-0.5 µgr/kg/min was used for intraoperative analgesia. The average duration of the surgery was 3.18 hrs ±0.64SD and anaesthesia was 3,7 hrs ±0.65SD . There were 135 67,5% male, 65 32,5% female patients and type of the transplantation was 123 living-related 61.5% and 77 cadaveric 38.5% . End stage renal disease ESRD reasons were hypertension 27.5%, n: 55 , diabetes mellitus 22.5%, n: 45 , unknown 18.5%, n: 37 , chronic glomerulonephritis 13.5%, n: 27 , amyloidosis 8.5%, n: 17 and others 9.5%, n: 19 in this study.Acute rejection was seen in 21 10.5% cases and the delayed graft function was seen in 27 13.5% cases. 24 12% patients died during post-transplantation period.DISCUSSION AND CONCLUSION: Renal transplantation is a good choice for chronic renal failure and anaesthetic management is so important for graft function. Our anaesthetic management and results are similar to the literature.

Anahtar Kelimeler

Anesthetic Management, Living Donors, Cadaveric Donors

200 hastada renal transplantasyon anestezisi deneyimlerimiz: Bir retrospektif çalışma

Öz

GİRİŞ ve AMAÇ: Böbrek nakli son dönem böbrek yetmezliği tedavisinde en iyi tedavi şeklidir. Anestezi yönetimi preoperatif, postoperatif ve intraoperatif dönem boyunca iyi planlanmalıdır. Böbrek nakli ile ilgili olarak birçok çalışma yapılmıştır. Bunlardan bazıları anestezi tekniklerini incelemiş olup bazıları anestezik ilaçların hasta ve nakil edilen böbrek üzerine etkilerini incelemişlerdir. Biz bu çalışmada böbrek nakli gerçekleştirilen 200 hastanın anestezi yönetimleriyle ilgili deneyimlerimizi sunmayı amaçladık. YÖNTEM ve GEREÇLER: Verileri elde etmek için hasta dosyaları kullanıldı. BULGULAR: Anestezi indüksiyonunda intravenöz ajanlardan propofol 2 mg/kg , fentanil 2-3 µgr/kg ve kas gevşetici olarak roküronyum 0.6 mg/kg veya atraküryum 0.6 mg/kg kullanıldı. Operasyonda anestezi idamesi için % 1-2 izofluran n: 67 , % 1-2 sevofluran n: 49 , % 6-7 desfluran kullanıldı. İntraoperativ analjezik olarak remifentanil 0.25-0.5 µgr/kg/min kullanıldı. Ortalama cerrahi süre 3.18 ±0.64 SS saat, ortalama anestezi süresi 3,7 ±0.65 SS saat olarak tespit edildi. Hastaların 135’i 67,5% erkek 65’i 32,5% kadındı ve 123 61.5% hastada canlıdan canlıya transplantasyon yapılırken 77 38.5% hastaya kadavradan yapılmıştır. Bu çalışmada hipertansiyon 27.5%, n: 55 , diabetes mellitus 22.5%, n: 45 , sebebi bilinmeyen 18.5%, n: 37 , kronik glomerulonefrit 13.5%, n: 27 , amiloidoz 8.5%, n: 17 and diğerleri 9.5%, n: 19 son dönem böbrek yetmezliği nedenleriydi. Akut rejeksiyon 21 10.5% hastada görülürken gecikmiş greft fonksiyonu 27 13.5% hastada görüldü. 24 12% hastada transplantasyon sonrası takiplerinde mortalite tespit edildi.TARTIŞMA ve SONUÇ: Renal transplantasyon böbrek yetmezliği tedavisi için iyi bir seçimdir ve anestezi yönetimi greft fonksiyonu için çok önemlidir. Bizim çalışmamızdaki anestezi yönetimi ve sonuçlarımız literatürle benzerdi.

Anahtar Kelimeler

Anestezi yönetimi, Canlı verici, Kadavra verici

Kaynakça

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