[Some aspects of epidural anesthesia in patients with chronic renal insufficiency]

In 231 patient with chronic renal impairment (CRI) the quality was studied of epidural anesthesia with different doses and concentrations of lidocaine hydrochloride, prilocaine hydrochloride, trimecaine hydrochloride, and bupivacaine. In patients in the terminal stage of CRI placed on the program-hemodialysis, the use of standard concentrations and volumes of the local anesthetsic (LA) has been found out to be associated with lower levels of the sensory and motor blocks than in CRI-free patients or in other stages of CRI. Intensification of epidural anesthesia in the above patients is achieved through employing a higher concentration of LA or epidural administration of narcotic analgesics and/or cloffelin. Patients with other stages of CRI do not require the renal-insufficiency stage-dependent correction of LA dose, an optimum option being administration of 2% solution of lidocaine and prilocaine, 2.5% solution of trimecaine and 0.5% solution of bupivacaine, 1.5% ml, on the spinal segment in combination with adjuvant drugs.