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Anesthetic Management of the Pregnant Patient with Renal Disease

  • Gulay Ok
Chapter

Abstract

Pregnancy leads to reversible anatomical and physiological changes in the renal system. The severity of kidney disease, biochemical tests of the pregnant woman, and accompanying comorbidities serve as guidelines in determining the anesthesia technique. Type of anesthesia to be performed in pregnancies with acute renal failure is different from pregnancies with chronic renal failure.

Nephrologists, anesthesiologists, and obstetricians should evaluate these cases with a multidisciplinary approach. Aspiration prophylaxis should always be performed in patients with chronic renal failure. If general anesthesia is to be administered, drugs with short duration of action and having elimination independent from the kidney (atracurium/cisatracurium, remifentanil, etc.) should be preferred. Neuraxial anesthesia is a good choice if there is no coagulopathy, thrombocytopenia, and platelet dysfunction. Invasive hemodynamic monitoring and vasopressors (phenylephrine or ephedrine) should be readily available to maintain renal perfusion during neuraxial anesthesia in major renal operations of complicated parturients.

Keywords

Acute renal failure Pregnancy Chronic renal failure Hemodialysis Anesthesia 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gulay Ok
    • 1
  1. 1.Manisa Celal Bayar University School of Medicine, Department of Anesthesiology and ReanimationManisaTurkey

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