Author/Authors :
Noraee، Navid نويسنده Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran , , Fathi، Mohammad نويسنده Department of Mining and Metallurgical Engineering, Amirkabir University of Technology, Tehran, Iran Fathi, Mohammad , Golestani Eraghi، Majid نويسنده Fellowship of Intensive Care, Department of Anesthesiology, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran , , Dabbagh، Ali نويسنده , , Massoudi، Nilofar نويسنده Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ,
Abstract :
Intraoperative care and anesthesia method in patients undergoing allograft renal transplantation surgery are very necessary. Acid-base imbalance can alter neuromuscular blockade and recovery time. The aim of the present study was to investigate the effect of acid-base balance on atracurium blockade in renal transplantation. In this randomized-controlled trial, 31 end-stage renal disease (ESRD) patients undergoing renal transplantation were randomly assigned into two equal groups. The case group received intravenous sodium bicarbonate based on base excess in the first ABG sample, while the control group received sterile water for injection during the interval between anesthesia and beginning of surgery. Arterial blood gas (ABG) sample was drawn first prior to surgery and again at declamping time. Train-of-four (TOF) was measured before anesthesia and repeatedly after declamping time until acceptable recovery (TOF 3 of 4). The time of achieving TOF 3 was recorded and compared between the groups. There was no significant difference in blood pH between the groups in the first evaluation (P = 0.649). The pH and base excess (BE) in the case group significantly increased after the intervention. There was a significant decrease in after-surgery measurement of pH in the control group (P = 0.011). The mean time to achieve TOF = 3 was 23.75 ± 5.32 and 41.80 ± 5.2 minutes after declamping in the case and control groups, respectively. Patients in the sodium bicarbonate group achieved TOF = 3 significantly faster than the control group. Based on our results, intraoperative alkali and acid-base imbalance treatment can reduce neuromuscular blockade and recovery time, and it can be regarded as a potential casual factor to enhance transplantation outcome.
