Ambulatory phlebectomy under tumescent local anesthesia in a kidney-transplant patient

作者：Bjelanovic Zoran^*; Lekovic Ivan; Draskovic Miroljub; Tomic Aleksandar; Veljovic Milic; Stamenkovic Dusica; Stankovic Nebojsa

来源：Vojnosanitetski Pregled, 2013, 70(4): 417-419.

DOI：10.2298/VSP1304417B

• varicose veins
• vascular surgical procedures
• anesthesia
• local
• ambulatory care
• treatment outcome
• kidney transplantation

Introduction. Tumescent local anesthesia (TLA) is widely used for ambulatory surgery. Patients with transplanted organs are on immunosuppressive therapy and with risk for organ rejection or severe infection. Case report. Saphenectomy with phlebectomy on the left leg under TLA was performed in a patient with kidney transplantation performed four years ago. A combination of 35 mg of 1% prilocaine-hydrochloride, 5 mL of 8.4% sodium bicarbonate and 500 mu g of epinephrine in 460 mL of normal saline was used for TLA. Overall 750 mL of the solution was used. The patient had satisfactory postoperative analgesia and was discharged home on the same day. Blood levels of urea, creatinine, estimated glomerular filtration rate (eGFR) and tacrolimus concentration, measured preoperatively and on the second postoperative day, were in a regular range. Prilocaine blood concentrations determined on the 4th, 10th and 16th postoperative hours, were below toxic levels. Conclusion. TLA in a kidney-transplanted patient performed for saphenectomy with phlebectomy proved to be a safe and reliable anesthesia method.

• 出版日期2013-4
• 单位中国人民解放军军事医学科学院