Summary
This paper reviews the anaesthetics given for a series of 126 consecutive bilateral nephrectomies. The special problems presented by these patients are described and they include primarily low haemoglobin, electrolyte imbalance and lack of useable veins following repeated dialysis and venipuncture for biochemical investigation. Many of these patients present with severe hypertension and an unstable cardiovascular system. A thiopentone, succinylcholine, d-tubocurare, nitrous oxide, oxygen and halothane anaesthetic sequence was used by preference. The results and complications of this technique are considered. There were no deaths associated with anaesthesia in this series in a four-month follow-up period.
Major and minor complications were reviewed. There were only a few complications directly attributable to anaesthesia. Changes following simultaneous bilateral nephrectomy are pointed out as they affect haemoglobin levels, transfusion requirements, blood pressure changes, and neuropathy. Experience in this series is compared to others reported.
Résumé
Cet article fait une revue des anesthésies donnnées pour une série de 126 anesthésies consécutives données pour des néphrectomies bilatérales. Nous décrivons les problèmes spéciaux que posent ces malades dont: une hémoglobine basse, un déséquilibre électrolytique et une absence de veine utilisable à cause des dialyses répétées et des ponctions veineuses pour étude biochimique. Plusieurs de ces malades sont porteurs d’hypertension grave et d’un système cardiovasculaire instable. De préférence il a été utilisé dans l’ordre: du pentothal, de la succinylcholine, de la d-tubocurarine, du protoxyde d’azote, de l’oxygène et de l’halothane. Nous analysons les résultats et les complications de cette technique. Aucune mortalité n'est reliée à l’anesthésie dans cette série sur une période de quatre mois de surveillance.
Nous avons étudié les complications mineures et majeures. Il n’y a eu que peu de complications directement attribuables à l’anesthésie. Les changements qui surviennent à la duite d’une néphrectomie bilatérale simultanée sont signalés car ils touchent le taux d’hémoglobine, l’exigence de transfusions, les modifications de la pression sanguine et les neuropathies. Nous comparons l’expérience de cette série à celle que rapportant les autres.
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Jenkins, L.C., Moloney, P.J. & Cyr, W. Anasthesia for simultaneous bilateral nephrectomy. Canad. Anaesth. Soc. J. 20, 259–273 (1973). https://doi.org/10.1007/BF03027164
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DOI: https://doi.org/10.1007/BF03027164