Abstract
We anesthetized a 41-year-old woman with chronic renal failure by administering spinal anesthesia, and had many difficulties controlling and managing the general condition of the patient during her femoral head replacement operation. She had been diagnosed as chronic renal failure 20 years ago, and has been under hemodilution for more than 10 years. The patient visited our hospital owing to left femur legion without traumatic history, and thenoperation was decided on diagnosis of her femoral neck fracture. We chose spinal anesthesia using 0.5 % bupivacaine which has little effect on hemodynamics. During the operation period, we used dopamin treatment and blood transfusion because of her hypotension. After the operation, hypotension and hyperkalemia continued to occur. Furthermore, an obstruction occured in her hemodilution shunt and bleeding occured in retroperitoneal cavity. However, the emergency hemodilution and chelating agent treatment was successful. Bleeding stopped within a few days. When anesthetizing chronic renal failure patients, many complications tend to occur. Therefore, it is necessary that anesthesiologists keep in mind the difficulties in the anesthetical treatment of chronic renal failure patients.
