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丙泊酚、瑞芬太尼和顺式阿曲库铵用于肾移植麻醉

[Anesthesia with propofol, remifentanil and cisatracurium in renal transplantation].

作者信息

Carmona García P, Peleteiro Pensado A, Jiménez de La Fuente C, Gago Quiroga S, Zaballos García M

机构信息

Hospital Universitario Gregorio Marañón, 28007 Madrid.

出版信息

Rev Esp Anestesiol Reanim. 2003 Aug-Sep;50(7):356-9.

Abstract

A 41-year-old woman with end-stage renal insufficiency in peritoneal dialysis for 3 years received a kidney transplant under anesthesia with remifentanil, propofol, and cisatracurium. She had a history of hypertension and was being treated with enalapril, metoprolol and erythropoietin. After anesthetic induction, blood pressure fell significantly and surgery was performed in a context of hemodynamic stability. The postoperative course was good, with a functional graft and adequate diuresis from the start. Anesthetics with minimal residual effects and as little renal toxicity as possible are ideal for use in kidney transplantation. The drugs used in this case had pharmacokinetic and pharmacodynamic properties that make them particularly appropriate for such patients.

摘要

一名41岁的女性,接受腹膜透析3年,处于终末期肾功能不全,在瑞芬太尼、丙泊酚和顺式阿曲库铵麻醉下接受了肾脏移植。她有高血压病史,正在接受依那普利、美托洛尔和促红细胞生成素治疗。麻醉诱导后,血压显著下降,手术在血流动力学稳定的情况下进行。术后过程顺利,从一开始移植肾就功能良好且利尿充足。具有最小残留效应且肾毒性尽可能小的麻醉剂是肾脏移植的理想用药。本病例中使用的药物具有药代动力学和药效学特性,使其特别适合此类患者。

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