Balanced anestesia versus total intravenous anestesia for kidney transplantation

• Published in: Minerva anestesiologica Vol. 72; no. 7-8; pp. 627 - 635
• Main Authors: Modesti, C, Sacco, T, Morelli, G, Bocci, M G, Ciocchetti, P, Vitale, F, Perilli, V, Sollazzi, L
• Format: Journal Article
• Language: English; Italian
• Published: Italy 01.07.2006
• Subjects: Adult; Anesthesia, General; Anesthesia, Intravenous; Anesthetics, Inhalation; Anesthetics, Intravenous; Female; Hemodynamics - physiology; Humans; Kidney Transplantation; Male; Middle Aged; Pain, Postoperative - drug therapy; Pain, Postoperative - epidemiology
• ISSN: 0375-9393

An ideal anesthetic regimen for kidney transplantation should be able to assure haemodynamic stability to obtain an optimal graft reperfusion. The aim of this study was to compare 2 regimens of anesthesia for patients submitted to kidney transplantation. We studied 40 patients: 20 subjects (Group A) received balanced anesthesia with thiopental, fentanyl and isoflurane, to the others 20 (Group B), a total intravenous anesthesia (TIVA) with propofol and remifentanyl was given. In both groups muscle relaxation was obtained with a bolus of cisatracurium followed by a continuous infusion. We performed standard clinical, invasive blood pressure and central venous pressure monitoring. Hemodyna-mic data have been collected at standard times. During the postoperative period we evaluated the recovery (Aldrete Score) in the recovery room and the analgesia (VAS) at 1, 6, 24 h after the end of surgery. The trend of hemodynamic parameters did not show statistically significant differences between the 2 groups. We observed statistically significant differences concerning the quality of the recovery and the postoperative analgesia. The recovery in group B was faster than in group A, but in group A the pain control was better than in group B at least during the first postoperative hour. For their pharmacokinetic properties, propofol, remifentanyl and cisatracurium allow to obtain a good control of the hemodynamic parameters and a fast and safe recovery of consciousness. Total intravenous anesthesia regimen seems to be an alternative to the balanced anesthesia for patients undergoing kidney transplantation.