Thoracic Epidural Analgesia after Lung Transplantation

Body, Simon C.; Fanciullo, Gilbert J.; Ferrante, M.; Reilly, J.; Dj, Sugarbaker; Mentzer, Steven J.

doi:10.1097/00000542-199409001-01285

Cited by 1 publication

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…77 Thomas and Siegel reported excellent postoperative analgesia and earlier extubation (13-hr postoperatively) in a SLT recipient administered a bolus ofepidural hydromorphone, 1.5 mg (in 10 ml preservative free saline), followed by an epidural infusion at 0.25.mg.hr -1.7s Body et al reported postoperative hypercapnia associated with epidural analgesia in a series of 29 patients undergoing SLT or BSLT. These patients received an epidural infusion of bupivacaine 0.125-0.25% (mean rate: 5.2-8.3 ml.hr -1) with either fentanyl 5 lag.m1-1 or meperidine 2.5 mg.ml-l. 79 Hypercapnia could have been due to the central action of epidural opioids, or to a failure to reset brainstem or peripheral chemoreceptors, or due to underlying mechanisms described previously. [67][68][69] …”

Section: Pain Managementmentioning

confidence: 99%

Perioperative anaesthetic considerations for patients undergoing lung transplantation

Singh

Bossard

1997

Can J Anaesth

View full text Add to dashboard Cite

Purpose: Five thousand, two hundred and eight lung transplants were performed worldwide before April, 1996. This review will discuss lung transplantation from an historical perspective, its indications, donor and recipient selection criteria, donor lung preparation, su~cal considerations, perioperative anaesthetic management, and associated morbidity and mortality. Source: Recent literature on perioperative anaesthetic management of lung transplantation and experience from international centres including the Toronto Lung Transplant Group and the St. Louis Lung Transplant Group. Principal fiadings: Lung transplantation comprises of a family of operations, including single lung transplant, bilateral single lung transplant, lobar transplant and block heart-lung transplant. Improved donor lung preservation techniques have increased the duration of cold ischaemic time. The advent of bilateral single lung transplant has decreased the requirement for cardiopulmonary bypass, and airway complications have been reduced by adoption of~e telescoping bronchial anastomoses. Advances in perioperative monitoring (including transoesophgeai echocardiography), pulmonary vasodilators (e.g., nitric oxide and prostaglandin El), carcliopulmonary bypass and ventilatory management, and a better understanding of the pathophysiological processes during the procedure have improved perioperative anaesthetic management. Also, advances in broad spectrum antibiotics and immunosuppressant drugs have improved the outcome by better management of the complications of infection and rejection. Conclusion: Lung transplantation improves the quality of life with marginal improvement in life expectancy of the recipients. It is an expensive procedure requiring continued resources for long term management of these patients.Objectif : jusqu'en avril 1996, cinq mille, deux cent huit transplantations de poumons avaient dEj,~ Et~ effectuL~,s ,~ travers le monde. Ce survol permettra de discuter de la transpl@~tion pulmonalre darts sa perspective historique, ses indications, les crit&es de s~lection du receveur et du donneur, la preparation du poumon du donneur, les consid&ations chirurgicales, la gestion p&iol~ratoire de ranesth~sie et la mortaiit~ et la morbidit~ assod~es. Source : Les publications r&entes traitant de la gestion p&iop&atoire de la transplantation pulmonaire et de l'exl:~rience acquise par des centres intemationaux dont le Toronto Lung Transplant Group et le St.Louis Lung Transplant Group. Princlpales r: la transplantation pulmonaire englobe une famille d'interventions dont la transplantation unipulmonaire, bilat&ale simple, Iobaire et coeur-poumons en bloc. I:am61ioration des techniques de pr6servation des poumons du donneur a permis ram~lioration de la durEe de risch6mie froide. I'av~nement de la transplantation bilat~rale simple a rEduit la n~cessitE de la circulation extracorporelle et rintroduction des anastomoses t~lescopiques a permis de r~duire les complications particuli&es aux voles a~dennes. Le perfectionnement du monitorage p~nop&a...

show abstract