Prolonged neuromuscular blockade and ventilatory failure after renal transplantation and cyclosporine

34Citations
Citations of this article
18Readers
Mendeley users who have this article in their library.

This article is free to access.

Abstract

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 O.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 fentanyllisoflurane and N2O/O2. After induction of anaesthesia, each patient received methylprednisolone, cefazolin, mannitol infusion for 24 hr beginning at the start of renal artery anastomosis, 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 inpatients who received cyclosporine (P < 0.05). © 1990 Canadian Anesthesiologists.

Cite

CITATION STYLE

APA

Sidi, A., Kaplan, R. F., & Davis, R. F. (1990). Prolonged neuromuscular blockade and ventilatory failure after renal transplantation and cyclosporine. Canadian Journal of Anaesthesia, 37(5), 543–548. https://doi.org/10.1007/BF03006323

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free