Abstract
We performed 24 kidney transplantations in a 4-year period. All of our patients were suffering from chronic nephritis. Some of them were in the terminal stage of uremia. They were hyperventilating to eliminate carbon dioxide and to compensate metabolic acidosis. They were anemic and hypertensive. Generalized edema or peripheral edema, sometimes even pulmonary edema was present. Nausea and vomiting were also present. They had water and electrolyte imbalance associated with acid-base imbalance. Fevering was seen commonly. For such a patient, we had to correct metabolic disorders and to avoid any anesthetics which affect kidney and other organ systems. We chose spinal anesthesia, especially continuous spinal anesthesia technic, for the purpose of kidney transplantation because this technic less affects renal circulation and provides enough muscle relaxation throughout the operative procedure. After the spinal anesthesia was established, 40 mg of succinylcholine were given and an endotracheal tube was inserted. Nitrous oxide and oxygen were inhaled and thiopental and sodium gamma-hydroxybutyrate were given intravenously as anesthetic adjuvant. Those are thought to be not nephrotoxic and the operations were performed without any problems. In our series, 15 out of 24 patients had undergone their kidney transplantation under continuous spinal anesthesia. In this clinical study, acid-base, electrolyte and other metabolites were examined before, during and after surgery. Postoperative cares are also discussed.
