Kumar Lakshmi, Sahu Sandeep, Deo Alka S, Selvakumar R, Panchwag Ameya A, Pavithran Priyanka
Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Department of Anaesthesiology, SGPGI, Lucknow, Uttar Pradesh, India.
Indian J Anaesth. 2023 Jan;67(1):32-38. doi: 10.4103/ija.ija_1025_22. Epub 2023 Jan 21.
Organ transplantation has undergone remarkable revolution in the last two decades and offers a scope for survival amongst patients with end-stage organ failure. Along with availability of advanced surgical equipment and haemodynamic monitors, minimally invasive surgical techniques have emerged as options for surgery both amongst the donors and recipients. Newer trends in haemodynamic monitoring and expertise in ultrasound guided fascial plane blocks have changed the management in both donors and recipients. The availability of factor concentrates and point-of-care tests for coagulation have allowed optimal and restrictive fluid management of patients. Newer immunosuppressive agents are useful in minimising rejection following transplantation. Concepts on enhanced recovery after surgery have allowed early extubation, feeding and shorter hospital stay. This review gives an overview of the recent progress in anaesthesia for organ transplantation.
在过去二十年中,器官移植经历了显著的变革,为终末期器官衰竭患者提供了生存的机会。随着先进手术设备和血流动力学监测仪的出现,微创外科技术已成为供体和受体手术的选择。血流动力学监测的新趋势以及超声引导筋膜平面阻滞技术的专业应用,改变了供体和受体的管理方式。凝血因子浓缩物和床旁凝血检测的出现,使得患者能够实现优化且限制性的液体管理。新型免疫抑制剂有助于减少移植后的排斥反应。术后加速康复理念使得患者能够早期拔管、进食,并缩短住院时间。本文综述了器官移植麻醉的近期进展。