Chinese Journal of Tissue Engineering Research ›› 2011, Vol. 15 ›› Issue (31): 5773-5776.doi: 10.3969/j.issn.1673-8225.2011.31.017

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Safety of combined spinal-epidural anesthesia during kidney transplantation in patients with uremia and heart failure

Zhang Cai-qin, Wu Ya-hui, Qiao Hui   

  1. Department of Anesthesiology, Zhengzhou People’s Hospital, Zhengzhou   45000, Henan Province, China
  • Received:2011-01-29 Revised:2011-03-05 Online:2011-07-30 Published:2011-07-30
  • About author:Zhang Cai-qin, Anesthesiology physician, Department of Anesthesia, Zhengzhou People’s Hospital, Zhengzhou 45000, Henan Province, China 812708928@qq.com

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Abstract:

BACKGROUND: Uremia combined with heart failure is not the contraindication of kidney transplantation, but anesthesia management is very difficult.
OBJECTIVE: To investigate the safety of combined spinal-epidural anesthesia during kidney transplantation in patients with uremia and heart failure.
METHODS: Under combined spinal-epidural anesthesia, 16 patients with heart failure underwent allogenic corpse kidney transplantation. Before and 10 minutes after anesthesia, before and after reperfusion of kidney transplant, and after kidney transplantation, systolic pressure, diastolic pressure, heart rate, and saturation of blood oxygen were determined.
RESULTS AND CONCLUSION: Compared with prior to anesthesia, systolic pressure, diastolic pressure and heart rate were significantly decreased (P < 0.05) and heart failure symptoms were obviously alleviated at 10 minutes after anesthesia. During the time period from transplantation initiation to transplantation termination, hemodynamical changes were stable, and patients’ heart failure symptoms were completely relieved. All 16 patients were safe during the period of anesthesia. These findings suggest that combined spinal-epidural anesthesia for kidney transplantation in patients with acute left heart failure can produce good anesthetic effects if anesthetic dose and administration speed are proper; in addition, it also can decrease cardiac afterload, improve heart and lung function, and maintain stable hemodynamics, without influence on blood perfusion of kidney transplant.

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