EFFECT OF PERIOPERATIVE FLUID MANAGEMENT AND ANAESTHETIC TECHNIQUE IN POSTOPERATIVE OUTCOME AFTER RENAL TRANSPLANTATION

Autor: Shafna K T, Mubarak K. K, Radhika K P
Rok vydání: 2015
Předmět:
Zdroj: Journal of Evidence Based Medicine and Healthcare, Vol 2, Iss 37, Pp 5881-5889 (2015)
ISSN: 2349-2570
2349-2562
DOI: 10.18410/jebmh/2015/811
Popis: BACKGROUND: Renal Transplantation provides near normal life to patients with end stage renal disease. Recent advances in medical management, immunosuppression, anaesthetic and surgical techniques have improved the success after renal transplantation. This study has f ocused on the effect of perioperative fluid management, anaesthetic technique and complications after renal transplantation. MATERIALS & METHODS : In this retrospective study, we reviewed all the cases (136) of renal transplantation conducted from January 2 012 to December 2014 at Government Medical College, Kozhikode. Patients were allocated into two groups, Combined Spinal Epidural Anaesthesia (group CSE) and General Anaesthesia with Epidural Analgesia (group GA+EDB). RESULTS: Of the 136 subjects, 66(48.53% ) were of group CSE and 70(51.47%) were of group GA+EDB. Of these, 127 patients received live related grafts (93.4%) and 9 cadaveric grafts (6.6%). Male patients predominated with 115(84.6%) whereas female patients were 21(15.4%). Intravenous fluid infused in Group GA+EDB were 5.2±1.53 Liter and 3.5±0.77 Liter in Group CSE with statistically significant p value of 0.000. Duration of surgery was 255±46.66 minutes in Group GA+EDB and 232 ± 31.79 minutes in Group CSE with a p value 0.001, statistically signifi cant. Average patient recovery time was 84.27 ± 39.63 minutes in Group GA+ EDB and 65.9 ± 20.48 minutes in Group CSE with a statistically significant p value of 0.001. There were three mortality in GA+EDB group, of which two were due to airway related problems and one due to refractory pulmonary oedema. CONCLUSION: Combined spinal epidural anaesthesia is a better choice for renal transplantation surgery than general anaesthesia. Optimal perioperative fluid therapy to maintain hemodynamic stability and graft fun ctioning with vigilant monitoring is the key to success.
Databáze: OpenAIRE
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