肾移植麻醉（Renal transplantation anesthesia）.docVIP

肾移植麻醉（Renal transplantation anesthesia） The above comrades from surgery contraindications and anesthesia on the talk about, the following I operate from the management notes, simple talk: 1. mechanical ventilation should be mild hyperventilation, so that the partial pressure of carbon dioxide (PaCO2) remained at 4.3-4.7kPa. 2., intraoperative blood pressure should be maintained at a high level, especially in the vascular anastomosis before the opening of blood flow, should not be less than 85% of preoperative blood pressure, intravenous drip of dopamine if necessary, so that the transplanted kidney has sufficient filtration pressure. 3. attention should be paid to the proportion of crystalloid fluid to colloid fluid in fluid replacement. Crystalloid solution is usually balanced with saline solution, which requires fresh blood loss after excessive bleeding. To avoid excessive fluid infusion, attention should be paid to enhancing intraoperative infusion control by closely monitoring central venous pressure. 4. renal transplant cycle should be re established, record the amount of urine, such as urine less or no urine, intravenous injection of furosemide and mannitol or calcium channel blocker verapamil. 5. monitoring of serum potassium, such as the case of hyperkalemia should immediately be given treatment, calcium gluconate or alkaline drugs, which also helps to improve the function of kidney transplantation. 6. renal graft vascular anastomosis before opening, followed by methylprednisolone 6-8mg/kg, intravenous injection of furosemide lOOmg slow intravenous infusion and intravenous cyclophosphamide, 200mg. If the blood pressure is low, give a small amount of DOPA intravenous drip. When necessary, the blood pressure can be added to keep the blood pressure at a slightly higher level than the preoperative blood pressure. 7., if the modern Xie acidosis, can enter 5% sodium bicarbonate to correct. 8. routine monitoring of blood pressure, ECG, pulse oxygen saturation, cent