Osswald P M
Anasth Intensivther Notfallmed. 1982 Sep;17(5):269-72.
The choice of the method of anaesthesia in patients with diseases of the liver and kidneys must never be dogmatic. If patients selected for surgery suffer from functional disturbances of these organs, the key to the therapeutic measures required within the framework of anaesthesia lies in an understanding of the pathophysiological peculiarities and the compensatory mechanisms of the body. It is only in this manner that the drugs required for anaesthesia can be satisfactorily dosed, and it is also the only manner by which a possible interaction on already induced drug therapy can be estimated as safely as possible. On-target preoperative findings yield important hints to the anaesthetist with regard to the patient's present situation, enabling him to select the most appropriate method of anaesthesia and to initiate the requisite additional measures even before surgery. For example, in case of concomitant diseases of the liver and the kidneys maximum safety can be guaranteed only if the opportunities of preoperative findings and preoperative therapy are properly utilised.
对于患有肝脏和肾脏疾病的患者，麻醉方法的选择绝不能教条。如果所选接受手术的患者存在这些器官的功能障碍，麻醉框架内所需治疗措施的关键在于了解身体的病理生理特点和代偿机制。只有通过这种方式，才能令人满意地确定麻醉所需药物的剂量，这也是尽可能安全地评估对已进行的药物治疗可能产生的相互作用的唯一方式。术前有针对性的检查结果能为麻醉医生提供有关患者当前状况的重要线索，使他能够选择最合适的麻醉方法，并甚至在手术前就启动必要的额外措施。例如，对于同时患有肝脏和肾脏疾病的情况，只有适当地利用术前检查结果和术前治疗的机会，才能确保最大程度的安全。
