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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient in chronic renal failure, who was receiving large doses of the combined alpha- and beta-blocking agent, labetalol, was selected for renal transplantation. A low concentration of halothane was used for induction and maintenance of anaesthesia, but severe myocardial depression occurred which proved unresponsive to atropine or isoprenaline, although it responded to a dopamine infusion. Synergism has already been reported between labetalol and high concentrations of halothane, but this case suggests that, in patients with previous myocardial damage, much lower concentrations of this inhalational agent may prove fatal.
Anaesthesia 1979 Mar
PMID:Synergism between halothane and labetalol. 37 19

Sixty patients, none of whom was suffering from renal failure, received neurolept anaesthesia. They were divided into six groups of 10 patients each. Groups I and IV, II and V, and III and VI were given suxamethonium 0.2, 0.6 and 1.0 mg kg-1 respectively. Groups IV-VI were pretreated with hexafluorenium 0.3 mg kg-1. The serum potassium concentration decreased significantly after the induction of anaesthesia and also following the administration of hexafluorenium. Neither suxamethonium 0.2 mg nor 0.6 mg kg-1 with or without hexafluorenium restored the potassium concentration to the control value. Suxamethonium 1.0 mg kg-1 alone caused the serum potassium to increase to values greater than control; hexafluorenium attenuated this effect. The combination of hexafluorenium and suxamethonium may be of benefit in patients who are anephric or are in chronic renal failure.
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PMID:Prevention of suxamethonium-induced changes in serum potassium concentration by hexafluorenium. Is their combined use justified? 44 45

To determine the risks of performing major surgical procedures on patients with chronic renal failure, the charts of twenty-nine hemodialysis patients who underwent thirty-eight elective and nine emergency operations were reviewed. Preoperative preparation included adequate hemodialysis of the patients, 88 per cent of whom were dialyzed within 24 hours of surgery. Azotemia was well controlled prior to administration of anesthesia. The average preoperative hematocrit was 26 per cent, and only one patient was hyperkalemic preoperatively. There were no intraoperative complications attributable to the patients' impaired renal function. Postoperative complications were frequent and are discussed in detail. Hemodialysis was done immediately postoperatively in five patients and on the first postoperative day in twenty-three additional patients with no problems. There were only two deaths (4.3 per cent) in the series. With careful monitoring during the perioperative period, major surgical procedures can safely be performed on patients with chronic renal failure.
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PMID:Major surgery in patients with chronic renal failure. 59 44

A case of pituitary adenoma operated on under hemodialysis was reported. The patient was a 43-year-old male who had been obliged to hemodialysis since April 1975 because of chronic renal failure. He was admitted in February 21, 1976 because of progressive visual symptoms. Neurological examination revealed decreased visual acuity and bitemporal hemianopsia. Radiology showed enlarged sella turcica and calcified mass in the suprasellar region. Laboratory examination disclosed severe anemia and the operation was postponed until the hematocrit improved up to 39% by blood transfusion. The operation was performed in March 17, 1976 under conventional GOF anesthesia. The tumor was covered by a calcified capsule and after nibbling off the calcified covering, the tumor was removed. Postoperative course was uneventful. Peritoneal dialysis was continued for three days immediately after operation. Urinary volume of the patient increased up to 600 ml per day after operation, probably due to the postoperative diabetes insipidus. The diabetes insipidus was rather favorable sequela in this case because the patient was released from the severe restriction of water intake.
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PMID:[Intracranial surgery under hemodialysis (author's transl)]. 63 44

A 33-year-old man with chronic renal failure underwent repair of an expanding aortic aneurysm. The management of the case is described and the anaesthetic problems discussed.
Anaesthesia 1978 Mar
PMID:Vascular surgery in an anephric patient. 64 76

A 52-year-old woman, on intermittent hemodialysis because of chronic renal failure, underwent total hip replacement for severe osteoarthritic changes. The operation was performed under epidural anesthesia, the postoperative course was uneventful, and the patient was completely relieved of pain and limitation of movement. Although total hip replacement is a major surgical procedure, it is suggested that the operation can, when considered necessary, by successfully carried out in a patient on hemodialysis, provided that careful attention is paid to the pre- and postoperative care.
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PMID:Total hip replacement in a patient on hemodialysis. 68 Nov 69

After consideration of surgical demands and patient condition, regional anesthesia is preferred for renal transplantation at the University of Rochester Medical Center. Of 75 consecutive cases, 64 were successfully managed with single high-dose spinal anesthesia (10 to 20 mg tetracaine, mean 16.5 mg). The technic avoids untoward effects of neuromuscular blocking drugs, iatrogenic pulmonary infection from anesthetic equipment, and problems with potent general and anesthetics. Patients are made comfortable by judicious low-dose sedation. Cardiovascular instability and blood loss are not troublesome. There have been no permanent neurologic sequelae or postspinal headaches. The authors believe this technic produces minimal biochemical and physiologic derangement for renal transplantation in the patient with chronic renal failure.
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PMID:A regional anesthetic approach for renal transplantation. 110 9

The aim the study was to investigate the effects of both alpha and beta adrenergic blockade on sodium and potassium excretion in rats with chronic renal failure. The chronic renal failure was induced by surgical ablation of 75% renal mass. Controls were shame operated rats. All experiments were performed under sodium pentobarbitone anesthesia. Blood pressure was measured intraarterially and glomerular filtration rate was estimated as inulin clearance. Phentolamine (4 micrograms/kg/min)--Group I; or propranolol (4 micrograms/kg/min)--Group II were infused i.v. to controls and chronic failure rats. alpha-receptor blockade with phentolamine lowered GFR and blood pressure to the same extent in controls and rats with chronic renal failure. alpha-blockade caused increased fractional sodium excretion only in controls while urinary excretion of sodium and potassium fell in rats with chronic renal failure. The beta-blockade with propranolol (4 micrograms/kg/min)--Group II did not affect both blood pressure and GFR either in controls nor in rats with chronic renal failure. However propranolol infusion increased sodium and potassium excretion in controls but not in rats with chronic renal failure. Our study showed the divergence in the role of adrenergic receptors in regulation of urinary electrolytes excretion between controls and rats with chronic renal failure.
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PMID:[Effects of alpha and beta receptor blockaders on urinary excretion of sodium and potassium in healthy rats and in those with chronic renal failure]. 152 37

Medical records of 68 horses with urolithiasis were examined. Calculi were in the bladder in 47 horses, urethra in 11 horses, kidneys in 15 horses, and ureter in two horses. They occurred at several sites in six horses. Common clinical signs included hematuria, altered micturition (pollakiuria, dysuria, urinary incontinence), and tenesmus. Weight loss, possibly attributable to chronic renal failure and colic, was associated more commonly with renal and ureteral calculi. Weight loss also occurred in 13% of horses with cystic calculi only. In male horses, most cystic calculi were removed by perineal (ischial) urethrotomy under epidural anesthesia. Although there were few surgical complications with urethrotomy, seven of 15 horses with follow-up suffered recurrent urolithiasis.
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PMID:Urolithiasis in 68 horses. 158 59

Between 1982 and 1990, 20 patients with chronic renal failure underwent total para-thyroidectomies and autotransplantations as treatment for secondary hyperparathyroidism. Fourteen cases were cured of their symptoms and their serum PTH levels was restored to normal. Recurrent hyperparathyroidism developed in 6 cases. In 3 of the 6 cases, excision of parathyroid tissue from the forearm could easily be performed under local anesthesia. Of the other cases, 2 had five and one had six glands. Several localizing methods should be performed before operation, in order to overlook the parathyroid glands in different anatomic positions.
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PMID:[Technique and problems of total parathyroidectomy with autotransplantation in secondary hyperparathyroidism]. 175 13


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