ゴトウ　シユンサク   後藤　俊作    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Anesthesia management in 14 cases of cesarean delivery in renal transplant patients-a single-center retrospective observational study.
掲載誌名	正式名：JA clinical reports 略　 称：JA Clin Rep ISSNコード：23639024/23639024
掲載区分	国外
巻・号・頁	6(1),pp.10
著者・共著者	Goto Shunsaku, Fukushima Risa, Ozaki Makoto
担当区分	筆頭著者
発行年月	2020/02
概要	BACKGROUND:The aim of this study was to investigate anesthesia management for cesarean delivery in renal transplant patients.METHODS:The details of anesthesia management, patient characteristics, surgical information, and renal and maternal outcomes were retrospectively investigated in 14 post-renal transplant patients who underwent cesarean delivery at a single university hospital between January 1, 2014, and August 31, 2018.RESULTS:Five patients were managed under general anesthesia, and nine cases were under regional anesthesia. Nine cases were emergency surgeries. The mean (SD) age was 35.5 (4.4) years, pregnancy body weight was 56.8 (10.0) kg, and gestational age was 33.3 (4.1) weeks. Nine cases were preterm deliveries. Five cases showed hypertension prior to pregnancy, and 13 patients showed hypertension before cesarean delivery. The preoperative creatinine level was 1.49 (0.53) mg/dL. The intraoperative maximum systolic/diastolic blood pressure was 170 (20)/102 (15) mmHg, and the intraoperative minimum systolic/diastolic blood pressure was 97 (13)/49 (12) mmHg. A total of six patients had either mean arterial pressure < 65 mmHg or required vasopressors. Serum creatinine remained unchanged after surgery compared with the preoperative level.CONCLUSION:Cesarean delivery was often performed in post-renal transplant patients for preterm delivery or as emergency surgery, with a higher ratio of regional anesthesia to general anesthesia. Since both hypertension and hypotension are most likely to occur during cesarean delivery, circulation management can be difficult, and anesthesia should be managed so as to maintain sufficient renal perfusion and ensure postoperative renal function.
DOI	10.1186/s40981-020-0317-z
PMID	32034536