title: Balanced anestesia versus total intravenous anestesia for kidney transplantation.
abstract: OBJECTIVE
  An ideal anesthetic regimen for kidney transplantation should be able to assure haemodynamic stability to obtain an optimal graft reperfusion. The aim of this study was to compare 2 regimens of anesthesia for patients submitted to kidney transplantation.
  
  
  METHODS
  We studied 40 patients: 20 subjects (Group A) received balanced anesthesia with thiopental, fentanyl and isoflurane, to the others 20 (Group B), a total intravenous anesthesia (TIVA) with propofol and remifentanyl was given. In both groups muscle relaxation was obtained with a bolus of cisatracurium followed by a continuous infusion. We performed standard clinical, invasive blood pressure and central venous pressure monitoring. Hemodyna-mic data have been collected at standard times. During the postoperative period we evaluated the recovery (Aldrete Score) in the recovery room and the analgesia (VAS) at 1, 6, 24 h after the end of surgery.
  
  
  RESULTS
  The trend of hemodynamic parameters did not show statistically significant differences between the 2 groups. We observed statistically significant differences concerning the quality of the recovery and the postoperative analgesia. The recovery in group B was faster than in group A, but in group A the pain control was better than in group B at least during the first postoperative hour.
  
  
  CONCLUSIONS
  For their pharmacokinetic properties, propofol, remifentanyl and cisatracurium allow to obtain a good control of the hemodynamic parameters and a fast and safe recovery of consciousness. Total intravenous anesthesia regimen seems to be an alternative to the balanced anesthesia for patients undergoing kidney transplantation.
authors.affiliation: Department of Anesthesia and Intensive Care, Policlinico A. Gemelli, Catholic University of Sacred Hearth, Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Modesti
authors.forename: T
authors.initials: T
authors.lastname: Sacco
authors.forename: G
authors.initials: G
authors.lastname: Morelli
authors.forename: M G
authors.initials: MG
authors.lastname: Bocci
authors.forename: P
authors.initials: P
authors.lastname: Ciocchetti
authors.forename: F
authors.initials: F
authors.lastname: Vitale
authors.forename: V
authors.initials: V
authors.lastname: Perilli
authors.forename: L
authors.initials: L
authors.lastname: Sollazzi
mesh_terms: D000328:Adult; D000768:Anesthesia, General; D000771:Anesthesia, Intravenous; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy / Q000453:epidemiology
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous