| Autor: |
Radkowski P; Department of Anesthesiology and Intensive Care, Faculty of Medicine, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland.; Department of Anesthesiology and Intensive Care, Regional Specialist Hospital, Olsztyn, Poland.; Department of Anesthesiology and Intensive Care, Hospital zum Heiligen Geist in Fritzlar, Fritzlar, Germany., Krupiniewicz KJ; Faculty of Medicine, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland., Suchcicki M; Faculty of Medicine, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland., Machoń NJ; Faculty of Medicine, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland., Cappello S; Faculty of Medicine and Surgery, University of Cagliari, Cagliari, Italy., Szewczyk M; Residency in Rheumatology, University Clinical Hospital No. 1 in Szczecin, Szczecin, Poland., Wolska JM; Department of Anaesthesiology and Intensive Care, Regional Specialist Hospital, Olsztyn, Poland., Stompór T; Department of Nephrology, Transplantology and Internal Diseases, Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland. |
| Abstrakt: |
This comprehensive review explores the interaction between neuromuscular blocking agents, reversal agents, and renal function, focusing on various drugs commonly used in anesthesia and their effects on kidney health. Succinylcholine, commonly used for anesthesia induction, can trigger elevated potassium levels in patients with specific medical conditions, leading to serious cardiac complications. While studies suggest the use of succinylcholine in patients with renal failure is safe, cases of postoperative hyperkalemia warrant further investigation. Some agents, such as atracurium and mivacurium, are minimally affected by impaired kidney function, whereas others, such as cisatracurium and rocuronium, can have altered clearance, necessitating dose adjustments in patients with renal failure. The reversal agents neostigmine and sugammadex affect renal markers, while cystatin C levels remain relatively stable with sugammadex use, indicating its milder impact on glomerular function, compared with neostigmine. Notably, the combination of rocuronium and sugammadex in rat studies shows potential nephrotoxic effects, cautioning against the simultaneous use of these agents. In conclusion, understanding the interplay between neuromuscular blocking agents and renal function is crucial for optimizing patient care during anesthesia. While some agents can be used safely in patients with renal failure, others can require careful dosing and monitoring. Further research is needed to comprehensively assess the long-term impact of these agents on kidney health, especially in high-risk patient populations. This article aims to review the use of muscle relaxants and reversal for anesthesia in patients with impaired renal function. |
