[Anesthesia in patients with liver and kidney diseases]

The choice of the method of anaesthesia in patients with diseases of the liver and kidneys must never be dogmatic. If patients selected for surgery suffer from functional disturbances of these organs, the key to the therapeutic measures required within the framework of anaesthesia lies in an understanding of the pathophysiological peculiarities and the compensatory mechanisms of the body. It is only in this manner that the drugs required for anaesthesia can be satisfactorily dosed, and it is also the only manner by which a possible interaction on already induced drug therapy can be estimated as safely as possible. On-target preoperative findings yield important hints to the anaesthetist with regard to the patient's present situation, enabling him to select the most appropriate method of anaesthesia and to initiate the requisite additional measures even before surgery. For example, in case of concomitant diseases of the liver and the kidneys maximum safety can be guaranteed only if the opportunities of preoperative findings and preoperative therapy are properly utilised.