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2013, Number 1

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Rev Mex Anest 2013; 36 (1)

Endotracheal nifedipine for intraoperative hypertensive crisis in renal transplant

Villegas-Anzo F, Castellanos-Olivares A, Gracida-Juárez C, Espinoza-Pérez R, Cansino-López J, Arellano-Muñoz JC, Vásquez-Márquez P, Soto-Palma G, Rangel-Montes MA

Language: Spanish
References: 27
Page: 26-31
PDF size: 115.97 Kb.


ABSTRACT

Introduction: Hypertension is a public health problem 1% development hypertensive crisis, with an incidence in the postoperative 4-35%. In patients with end stage renal disease undergoes kidney transplantation, when the diastolic is above 130 mmHg should be install emergency treatment. Objective: To determinate the hemodynamic response to endotracheal nifedipine administration during the intraoperative in patients with acute hypertension crisis in kidney transplantation. Design: Case series. Material and methods: We review records of 1,033 kidney transplants, finding 31 cases had hypertension diastolic above 130 mmHg during the transanesthesic. Each patient was given the content of 10 mg nifedipine capsule through endotracheal tube; we measured the hemodynamic changes 10 minutes. We recorded sex, age, weight, height, systolic blood pressure (SBP), diastolic blood pressure (DBP), medium arterial pressure (MAP) and central blood pressure (CVP). Results: No differences in age, weight, height. The ejection fraction was 47.7%. ASA IV patients were those who had more cardiovascular complications. The initial MAP 149 ± 9.22 mmHg with final MAP of 98 ± 8.9 mmHg, statistical difference (p ‹ 0.05). In the initial/final stage were analyzed DBP 130 ± 12/88 ± 8; CVP 16 ± 2/10 ± 3, finding statistical significance (p ‹ 0.05). Conclusions: Nifedipine endotracheal is effective and safe alternative for the treatment of patients with hypertensive crisis during kidney transplantation.


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