CJA
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text (PDF)
Right arrow Submit a scholarly reply
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Sidi, A.
Right arrow Articles by Davis, R. F.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sidi, A.
Right arrow Articles by Davis, R. F.

Canadian Journal of Anesthesia, Vol 37, 543-548, Copyright © 1990 by Canadian Anesthesiologists' Society

ARTICLES

Prolonged neuromuscular blockade and ventilatory failure after renal transplantation and cyclosporine

A Sidi, RF Kaplan and RF Davis
Department of Anesthesiology, University of Florida College of Medicine, J. Hillis Miller Health Center, Gainesville 32610-0254.

In a retrospective one-year study, we documented respiratory failure or prolonged neuromuscular blockade in eight of 65 patients with chronic renal failure who had received either vecuronium (four of 29 patients) or atracurium (four of 36 patients) during anaesthesia for kidney transplantation. We reviewed the charts of the patients and recorded all aspects of medication and anaesthesia to try to determine whether there might be a single factor associated with this high incidence (12 per cent) of respiratory failure. Anaesthesia for all patients was induced with thiopentone, isoflurane, and N2O/O2. Tracheal intubation was facilitated with muscle relaxants in a single bolus of vecuronium, 0.07 to 0.1 mg.kg-1, or atracurium, 0.3 to 0.5 mg.kg-1. Additional doses were given according to neuromuscular activity, which was monitored visually by response to train-of-four and tetanic stimulation. Anaesthesia was maintained with fentanyl/isoflurane and N2O/O2. After induction of anaesthesia, each patient received methylprednisolone, cefazolin, mannitol infusion for 24 hr beginning at the start of renal artery anatomosis, and either azathioprine (n = 57) or cyclosporine (n = 8). Relaxation was evaluated toward the end of the operation by train-of-four stimulation. Neuromuscular blockade was reversed with edrophonium (0.75-1 mg.kg-1) or neostigmine (0.06-0.08 mg.kg-1). The eight patients with prolonged neuromuscular blockade received ventilatory support for one to three hours after operation. Respiratory failure was significantly more frequent in patients who received cyclosporine (P less than 0.05).


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
R. G. Craig and J. M. Hunter
Recent developments in the perioperative management of adult patients with chronic kidney disease
Br. J. Anaesth., September 1, 2008; 101(3): 296 - 310.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Kostopanagiotou, V. Smyrniotis, N. Arkadopoulos, K. Theodoraki, L. Papadimitriou, and J. Papadimitriou
Anesthetic and Perioperative Management of Adult Transplant Recipients in Nontransplant Surgery
Anesth. Analg., September 1, 1999; 89(3): 613 - 613.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1990 by the Canadian Anesthesiologists' Society.