Regional anesthetic procedures in immunosuppressed patients

Gronwald, Carsten; Vowinkel, Thorsten; Hahnenkamp, Klaus

doi:10.1097/aco.0b013e32834cd2f0

Cited by 33 publications

(27 citation statements)

References 56 publications

(51 reference statements)

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“…Most cases received a combination of immunosuppressants and corticosteroids during pregnancy. Although the incidence of epidural abscess caused by regional anesthesia in parturients after renal transplant remains unknown, patients receiving immunosuppressants are vulnerable to infections [12], suggesting that epidural abscess would be more commonly caused by neuraxial anesthesia in those women and strict aseptic techniques are recommended. We removed epidural catheters within 48 h in all patients in order to prevent infections following the suggestion by Gronwald [12].…”

Section: Discussionmentioning

confidence: 99%

Anesthesia management in 14 cases of cesarean delivery in renal transplant patients—a single-center retrospective observational study

2020

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Background: The aim of this study was to investigate anesthesia management for cesarean delivery in renal transplant patients. Methods: The details of anesthesia management, patient characteristics, surgical information, and renal and maternal outcomes were retrospectively investigated in 14 post-renal transplant patients who underwent cesarean delivery at a single university hospital between January 1, 2014, and August 31, 2018. Results: Five patients were managed under general anesthesia, and nine cases were under regional anesthesia. Nine cases were emergency surgeries. The mean (SD) age was 35.5 (4.4) years, pregnancy body weight was 56.8 (10.0) kg, and gestational age was 33.3 (4.1) weeks. Nine cases were preterm deliveries. Five cases showed hypertension prior to pregnancy, and 13 patients showed hypertension before cesarean delivery. The preoperative creatinine level was 1.49 (0.53) mg/dL. The intraoperative maximum systolic/diastolic blood pressure was 170 (20)/ 102 (15) mmHg, and the intraoperative minimum systolic/diastolic blood pressure was 97 (13)/49 (12) mmHg. A total of six patients had either mean arterial pressure < 65 mmHg or required vasopressors. Serum creatinine remained unchanged after surgery compared with the preoperative level. Conclusion: Cesarean delivery was often performed in post-renal transplant patients for preterm delivery or as emergency surgery, with a higher ratio of regional anesthesia to general anesthesia. Since both hypertension and hypotension are most likely to occur during cesarean delivery, circulation management can be difficult, and anesthesia should be managed so as to maintain sufficient renal perfusion and ensure postoperative renal function.

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Section: Discussionmentioning

confidence: 99%

Anesthesia management in 14 cases of cesarean delivery in renal transplant patients—a single-center retrospective observational study

2020

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“…In immunocompromised patients, regional anesthesia (peripherial nerve block and neuroaxial block) can be useful and should be considered in order to enable appropriate management of pain and reduce the risk for this patients. 8 The operation of our patient was performed under regional anesthesia, as preferred by the organ transplant centers because it provides better perfusion of organs. 8 Although the combined spinal-epidural anesthesia is more adequate choice, we were afraid of infection and other complications, although most of the available literature does not specify a higher incidence of these complications.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Transplant Patient For Non-Transplant Surgery

Švraka¹,

Švraka²,

Milanović³

et al. 2017

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We present the case of a successfully operated patient with a kidney transplanted due to varicose veins of the right leg. A renal transplantation was performed eight years ago in a regional transplant center and since then, the patient has regularly been under nephrologist controls on immunosuppressive therapy with the proper function of the transplanted organ. The surgical procedure for vascular intervention was performed under spinal anesthesia, without perioperative complications. On the fourth postoperative day, the patient was discharged. The goal of this paper is to describe perioperative assessment and tretmant of the patients with a transplanted kidney.

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“…Es gibt ein theoretisches Risiko für eine erhöhte Inzidenz an Infektionen durch die Anlage peripherer Regionalanästhesien (Katheterverfahren > Single Shot) oder neuroaxialer Verfahren: Dies konnte allerdings nie belegt werden [16]…”

Section: Regionalanästhesie Merkeunclassified

Anästhesiologisches Management von herz- und lungentransplantierten Patienten

Karsten¹

2020

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungDie Zahl herz- und lungentransplantierter Patienten wächst stetig und ihre Lebenserwartung steigt. Somit nimmt auch die Wahrscheinlichkeit zu, dass einige dieser Patienten Komorbiditäten entwickeln, die einen chirurgischen Eingriff erfordern. Das perioperative anästhesiologische Management herz- und lungentransplantierter Patienten ist eine große Herausforderung – dieser Beitrag gibt einen Überblick.

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Regional anesthetic procedures in immunosuppressed patients

Cited by 33 publications

References 56 publications

Anesthesia management in 14 cases of cesarean delivery in renal transplant patients—a single-center retrospective observational study

Anesthesia management in 14 cases of cesarean delivery in renal transplant patients—a single-center retrospective observational study

Treatment of Transplant Patient For Non-Transplant Surgery

Anästhesiologisches Management von herz- und lungentransplantierten Patienten

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