Anesthetic considerations for pericardectomy in uremic pericardial effusion

Fifteen patients with impending uremic cardiac tamponade underwent either anterior pericardectomy or pericardiostomy under general anesthesia. Anesthetic agents and technics were selected in the light of physiopathologic derangements involving fluids and electrolyte balance, excretory and cardiovascular disturbances, and pharmacodynamics. Anesthesia was induced with diazepam and maintained with N2O-O2 (70:30) and fentanyl. Pancuronium was used for muscle relaxation. Adequate preoperative assessment of patient, careful monitoring of vital signs, maintenance of the critical balance of fluid and blood replacement, and selection of anesthetic agents for minimal depression of vital multiorgan systems provided excellent results. No postanesthetic morbidity or mortality occurred.