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말기신부전 환자의 구강외과 수술 마취관리
Anesthetic Management of the Oral and Maxillofacial Surgery in a Patient with End-Stage Renal Disease

대한치과마취과학회지 2003년 3권 2호 p.98 ~ 102

박창주, 박종철, 이원덕, 명훈, 이종호, 김명진, 김현정, 염광원,

소속 상세정보

박창주 ( Park Chang-Joo ) - 서울대학교 치과대학 치과마취과학교실
박종철 ( Park Jong-Chul ) - 서울대학교 치과대학 구강악안면외과학교실
이원덕 ( Lee Won-Deok ) - 서울대학교 치과대학 구강악안면외과학교실
명훈 ( Myoung Hoon ) - 서울대학교 치과대학 구강악안면외과학교실
이종호 ( Lee Jong-Ho ) - 서울대학교 치과대학 구강악안면외과학교실
김명진 ( Kim Myung-Jin ) - 서울대학교 치과대학 구강악안면외과학교실
김현정 ( Kim Hyun-Jeong ) - 서울대학교 치과대학 치과마취과학교실
염광원 ( Yeom Kwang-Won ) - 서울대학교 치과대학 치과마취과학교실

KMID : 0980220030030020098 DOI : 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 time a week and secondary hypertension with left ventricular hypertrophy was accompantied He also had chronic metabolic acidosis and hyperkalemia. The day after hemodialysts, general anesthesia was carried out. Uneventful anesthetic induction using thiopental and vecuronium and nasotracheal intubation were carries out. General anesthesia was maintained with isoflurane for 9 horse. 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.