A regional anesthetic approach for renal transplantation

After consideration of surgical demands and patient condition, regional anesthesia is preferred for renal transplantation at the University of Rochester Medical Center. Of 75 consecutive cases, 64 were successfully managed with single high-dose spinal anesthesia (10 to 20 mg tetracaine, mean 16.5 mg). The technic avoids untoward effects of neuromuscular blocking drugs, iatrogenic pulmonary infection from anesthetic equipment, and problems with potent general and anesthetics. Patients are made comfortable by judicious low-dose sedation. Cardiovascular instability and blood loss are not troublesome. There have been no permanent neurologic sequelae or postspinal headaches. The authors believe this technic produces minimal biochemical and physiologic derangement for renal transplantation in the patient with chronic renal failure.