Linke C L, Merin R G
Anesth Analg. 1976 Jan-Feb;55(1):69-73.
After consideration of surgical demands and patient condition, regional anesthesia is preferred for renal transplantation at the University of Rochester Medical Center. Of 75 consecutive cases, 64 were successfully managed with single high-dose spinal anesthesia (10 to 20 mg tetracaine, mean 16.5 mg). The technic avoids untoward effects of neuromuscular blocking drugs, iatrogenic pulmonary infection from anesthetic equipment, and problems with potent general and anesthetics. Patients are made comfortable by judicious low-dose sedation. Cardiovascular instability and blood loss are not troublesome. There have been no permanent neurologic sequelae or postspinal headaches. The authors believe this technic produces minimal biochemical and physiologic derangement for renal transplantation in the patient with chronic renal failure.
在综合考虑手术需求和患者状况后,罗切斯特大学医学中心更倾向于在肾移植手术中采用区域麻醉。在连续75例病例中,64例通过单次大剂量脊麻(10至20毫克丁卡因,平均16.5毫克)成功完成手术。该技术避免了神经肌肉阻滞药物的不良影响、麻醉设备引起的医源性肺部感染以及强效全身麻醉剂的相关问题。通过合理使用低剂量镇静剂可使患者感到舒适。心血管不稳定和失血问题并不棘手。未出现永久性神经后遗症或脊麻后头痛。作者认为,该技术对慢性肾衰竭患者的肾移植所产生的生化和生理紊乱最小。