Böbrek transplantasyonu yapılan hastalarda anestezi yönetimi
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Dosyalar
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi Tıp Fakültesi Dergisi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Son dönem böbrek yetmezliği olan hastalarda yaşam kalitesini olumlu yönde arttıran en seçkin tedavi yöntemi böbrek transplantasyonudur. Bu araştırmanın amacı, böbrek transplantasyonunun anestezi yönetimi ve sonuçları ile ilgili dikkat edilmesi gereken noktaları sunmaktır. Gereç ve Yöntemler: 2012 yılında son dönem böbrek yetmezliği nedeni ile Turgut Özal Tıp Merkezinde böbrek transplantasyonu yapılan 33 hasta retrospektif olarak değerlendirildi. Hastaların özellikleri, bulguları, takip kayıtları hastanemizin elektornik veri sisteminden ve anestezi takip formundan incelendi. Bulgular: Böbrek tarnsplantasyonu yapılan terminal dönem böbrek yetmelizkli hastaların ortalama yaşı 33,6±14,4 yıl idi. Nakil yapılan böbreklerin 9’u (%27) kadavradan, 24’ü (%73) canlı donörden elde edildi. Hastaların ikisinde (%6) entübasyon güçlüğü gözlendi. Anestezi süresi ortalama 216±64 dakika olup, organların sıcak iskemi süresi 158±110 saniye, total iskemi süresi ortlama 450±178 dakika olarak bulundu. Anestezi idamesinde hastaların 15’inde (%45) desfluran ve 18'inde (%55) izofluran kullanıldı. Hastaların 23’üne (%70) santral kateter ve ikisine (%6) diyaliz kateteri uygulandı. İntraoperatif dönemde 125±20 mg mannitol ve 87±68 mg furosemid verildi. Ameliyat sırasında dört hastaya eritrosit süspansiyonu verildi. Hastalarımızda intraoperatif anestezi ile ilişkili herhangi bir komplikasyon gelişmedi .Hastane kalış süresi ortalama 6,6±3,8 gün bulundu. Bir hasta nakil dışı bir komplikasyon nedeni ile kaybedildi. Sonuç: Böbrek transplantasyonu yapılan hastalarda detaylı preoperatif hazırlık, uygun perioperatif sıvı yönetimi ve hedefe yönelik hemodinamik uygulama gereklidir.
Aim: Renal transplantation is one of the important treatment modalities in patients with end-stage renal failure and improves the quality of life. The aim of the present study is to determine the important issues of the anesthetic management in renal transplantation. Material and Methods: We evaluated 33 patients who underwent renal transplantation due to end-stage renal failure at Turgut Ozal Medical Center in 2012. The patients’ characteristics and medical records were collected. Results: The mean age of the patients was 33.6±14.4 years. Nine (27%) kidneys from cadavers and 24 (73%) kidneys from a living donor were obtained for transplantation. Difficult intubation was observed in 2 patients (6%). The anesthesia duration was 216±64 minutes, warm ischemia time was 158±110 seconds, and total ischemia time was 450±178 minutes. Desflurane was used in 15 patients (45%), and isoflurane was used in 18 of patients (55%) during the anesthesia. Central venous catheterization was performed in 23 patients (70%), and catheterization for dialysis was performed. During the operation, total administrated dose of mannitol was 125±20 mg and furosemid dose was 87±68 mg. Red blood cell suspension was required in 4 patients during surgery. Intraoperative anesthesia-related complications were not observed. Duration of hospital stay was 6.6±3.8 days. One patient died due to non-transplant complications. Conclusion: In renal transplantation, detailed preoperative preparation, appropriate fluid and hemodynamic management should be performed.
Aim: Renal transplantation is one of the important treatment modalities in patients with end-stage renal failure and improves the quality of life. The aim of the present study is to determine the important issues of the anesthetic management in renal transplantation. Material and Methods: We evaluated 33 patients who underwent renal transplantation due to end-stage renal failure at Turgut Ozal Medical Center in 2012. The patients’ characteristics and medical records were collected. Results: The mean age of the patients was 33.6±14.4 years. Nine (27%) kidneys from cadavers and 24 (73%) kidneys from a living donor were obtained for transplantation. Difficult intubation was observed in 2 patients (6%). The anesthesia duration was 216±64 minutes, warm ischemia time was 158±110 seconds, and total ischemia time was 450±178 minutes. Desflurane was used in 15 patients (45%), and isoflurane was used in 18 of patients (55%) during the anesthesia. Central venous catheterization was performed in 23 patients (70%), and catheterization for dialysis was performed. During the operation, total administrated dose of mannitol was 125±20 mg and furosemid dose was 87±68 mg. Red blood cell suspension was required in 4 patients during surgery. Intraoperative anesthesia-related complications were not observed. Duration of hospital stay was 6.6±3.8 days. One patient died due to non-transplant complications. Conclusion: In renal transplantation, detailed preoperative preparation, appropriate fluid and hemodynamic management should be performed.
Açıklama
[Turgut Özal Tıp Merkezi Dergisi, (2013).20 (4)]
Anahtar Kelimeler
Böbrek Transplantasyonu, Anestezi Yöntemi, Renal Transplantation, Anesthesia Management
Kaynak
Turgut Özal Tıp Merkezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
20
Sayı
4
Künye
Aydoğan, M. Said., Çolak, Y. Ziya.,Pişkin, T.,Ünal, B.,Toprak, H. İlksen.,Durmuş, M.,(2013).Böbrek transplantasyonu yapılan hastalarda anestezi yönetimi.Turgut Özal Tıp Merkezi Dergisi, 20 (4).318-321 ss.
