J Korean Dent Soc Anesthesiol.  2003 Dec;3(2):98-102. 10.17245/jkdsa.2003.3.2.98.

Anesthetic Management of the Oral and Maxillofacial Surgery in a Patient with End-Stage Renal Disease: A Case Report

• Park CJ
• Park JC
• Kang YH
• Myoung H
• Lee JH
• Kim MJ
• Kim HJ
• Yum KW

• KMID: 2345173
• DOI: http://doi.org/10.17245/jkdsa.2003.3.2.98

Abstract

Patients in end-stage renal disease (ESRD) and chronic renal failure present a number of challenges to the anesthesiologist. They may be chronically ill and debilitated and have the potential for multiorgan dysfunction. A 65-year-old male patient with ESRD was scheduled for oral cancer surgery under general anesthesia. He was in regular hemodialysis three times a week and secondary hypertension with left ventricular hypertrophy was accompanied. He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysis, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carried out. General anesthesia was maintained with isoflurane for 9 hours. During the anesthesia, he did not have any problem but persistently increasing serum potassium level. After anesthetic emergence, he was transferred to intensive care unit for mechanical ventilation. So we report this successful case of anesthetic management in a patient with ESRD for oral cancer surgery, which massive bleeding and long anesthetic time were inevitable in, from the preoperative preparation to anesthetic emergence.

Keyword

Anesthesia, General; Kidney failure, Chronic; Cancer, Oral

MeSH Terms

Acidosis
Aged
Anesthesia
Anesthesia, General
Chronic Disease
Hemorrhage
Humans
Hyperkalemia
Hypertension
Hypertrophy, Left Ventricular
Intensive Care Units
Intubation
Isoflurane
Kidney Failure, Chronic*
Male
Mouth Neoplasms
Potassium
Renal Dialysis
Respiration, Artificial
Surgery, Oral*
Thiopental
Vecuronium Bromide
Isoflurane
Potassium
Thiopental
Vecuronium Bromide