In this case report, we have presented our anaesthetic management in a patient undergoing urgent abdominal surgery who has undergone renal transplantation before, and has been in a chronic haemodialysis program two times a week. Anaesthesia was induced with sevoflurane in nitrous oxide-oxygen mixture via a mask and maintained with sevoflurane 1.5% in N2O:O2 (50%:50%). A bolus dose of atracurium 25 mg was administered intravenously and intubation was done. Standard monitoring consisted of an electrocardiogram, non-invasive arterial pressure and pulse oximetry. Serum creatinine, potassium, sodium and blood urea nitrogen levels and also creatinine clearance were measured preoperatively and in the first, second, third and seventh postoperative days. Surgical cholecystectomy was performed and the duration of anaesthesia was 60 minutes.We conclude that sevoflurane does not aggravate renal impairment in measured parameters (serum creatinine, blood urea nitrogen and creatinine clearense) of renal function and does not change the time for haemodialysis in the patient with renal insufficiency. Introduction In addition to care being shown in the selection of drugs and agents in anaesthesia in renal insufficiency cases that will not increase renal damage and whose degradation will be independent of the kidney, care must also be taken regarding such situations as hypoxia and ischaemia (1).Sevoflurane, an inhalation anaesthetic, is used in anaesthesia induction by mask due to such features as its pleasant smell, the way it does not cause irritation in the respiratory channels, and rapid induction (2).In this report we describe the anaesthesia method used in a case with a transplanted kidney, undergoing dialysis twice a week, taken for emergency acute abdominal surgery. Case Report A 48-year-old male weighing 70 kg and 172 cm tall had received a right kidney transplant 11 years previously due to chronic renal insufficiency. Cyclosporin (Sandimmun, Novartis) 3 x 350 mg, mycophenolate mophetil (CellCept, Roche) 3 x 250 mg and prednisolone (Deltacortil, Pfizer) 1 x 5 mg were used for immunosuppressant treatment. The patient's kidney functions had followed a normal course until three months previously, when he presented to hospital with high fever and complaints of swelling in the hands and feet. In measured parameters serum creatinine was 7.1 dL-1, BUN 64 mg dL-1, and potassium 4.5 mmol mg dL-1 and the patient was admitted to hospital. Due to urinary excretion of 500 ml on the first day and a total of 700 ml on the second, high BUN and creatinine, a creatinine clearance level of 6 mL min-1 and hypervolemia, he was admitted to the dialysis program twice a week. On day 20 of hospitalization ultrasonography of the patient, who had pain in the upper right abdominal region, nausea and fever, was compatible with cholelithiasis. He was diagnosed with acute abdomen and taken for emergency surgery. Following routine monitoring (ECG, non-invasive blood pressures, peripheral oxygen saturation) sevoflurane induction by mask was performed while talking to the patient. Sevoflurane was commenced at 5% and the patient's respiration and sedation level were gradually reduced. Following muscle relaxation with atracurium 25 mg, intubation was performed. Anaesthetic maintenance was established with sevoflurane 1.5% and an oxygen/N2 (40%/60%) mixture. There was no evident intraoperative change in initial blood pressure values of 140/90 mmHg, pulse values of 84 beats min-1, or oxygen saturation values of 96%, and these continued within normal levels. A total of 500 ml of 0.9% NaCl was administered intraoperatively. Cholecystectomy was performed, with surgery duration recorded as 50 min and length of anaesthesia as 60 min. Following the operation, the patient was wakened by turning off the sevoflurane and extubated. Recovery was good and rapid. No complications were observed. The patient's preoperative and postoperative days 1st, 2nd, 3rd, and 7th serum creatinine, BU
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机译：在本案报告中，我们在经历了迫切性腹部手术的患者之前介绍了我们之前的患者的麻醉剂管理，并在每周两次慢性血液透析计划。通过掩模在氧化氮氧混合物中用七氟醚诱导麻醉，并在N 2 O 2（50％：50％）中保持七氟醚1.5％（50％：50％）。静脉内施用25mg的伞菌剂量，并进行插气。标准监测由心电图，非侵入动脉压和脉搏血氧测定组成。术前和在术后第一个，第二，第三和第七个术后，测量血清肌酐，钾，钠和血尿尿素水平以及肌酐清除率。进行手术胆囊切除术，麻醉的持续时间为60分钟。得出结论，七氟醚在肾功能的测量参数（血清肌酐，血尿尿素和肌酐清除）中不会加剧肾功能的肾损伤，并且不会改变患者血液透析的时间肾功能不全。简介除了在肾功能不全的麻醉中出现的药物和药剂中显示，不会增加肾脏损害，其退化将独立于肾脏，还必须考虑缺氧和缺血的情况（1 ）.SevofluRane，一种吸入麻醉剂，用于麻醉引起的掩模引起的，因为这种特征由于其令人愉快的气味，在呼吸道通道中不会引起刺激的方式，快速诱导（2）。本报告我们描述了麻醉用于移植的肾脏的情况下使用的方法，每周进行两次透析，用于紧急急性腹部手术。案例报告了一个48岁的男性，重量70公斤，172厘米的高172厘米，由于慢性肾功能不全，11年内接受了右肾移植。环孢菌素（Sandimmun，Novartis）3 x 350 mg，霉酚酸酯，霉菌（Cellcept，roche）3 x 250mg和泼尼松龙（Deltacortil，Pfizer）1×5mg用于免疫抑制治疗。患者的肾功能遵循正常的课程，直到以前三个月，当时他向医院发表了高烧和手中肿胀的抱怨。在测量的参数中，血清肌酐是7.1dL-1，BUN 64mg DL-1和4.5mmol Mg DL-1和患者进入医院。由于尿液排泄了500 ml，第二个，高面包和肌酐总共700毫升，肌酐清除水平6mL min-1和高血症，他每周两次被送入透析计划。在患有患者的患者的住院过度分泌的第20天，患有右上腹部区域，恶心和发烧的患者，与胆石病相容。他被诊断出患有急性腹部并进行急诊手术。在与患者交谈时进行常规监测（ECG，非侵袭性血压，外周氧饱和度）七氟醚诱导。七氟烷在5％开始，患者的呼吸和镇静水平逐渐减少。在用蹄术25mg肌肉弛豫之后，进行插管。用七氟醚1.5％和氧/ N 2（40％/ 60％）混合物建立麻醉维持。初始血压值140/90mmHg的初始血压值没有明显的术中变化，脉冲值84次拍摄最小1，或96％的氧饱和值，并且这些持续在正常水平内。术中施用总共500ml 0.9％NaCl。进行胆囊切除术，手术持续时间记录为50分钟，麻醉长度为60分钟。在操作之后，通过关闭七氟烷并拔管患者。恢复很好，迅速。没有观察到任何并发症。患者的术前和术后第1天，第2天，第3和第7次血清肌酐，BU
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