Effects Of Intraoperative Norepinephrine On Hemodynamics And Postoperative Renal Function In Kidney Transplantation

Objective:To explore the effects of norepinephrine and dopamine on hemodynamics and its clinical significance during renal transplantation.Method(s):Thirty-four patients received the allogeneic renal transplantation were randomly divided into norepinephrine group(N group)and dopamine group(D group),17 cases in each group,after induction of anesthesia,norepinephrine was infused in group N by 0.03-0.3ug ·cg-1 min-1,and dopamine was infused in group D by 1-10ug · kg-1 · min-1,which should be infused till the end of surgery.After completion,adjust the rate of infusion to maintain intraoperative MAP fluctuations no more than 20%of the baseline level.The anesthetic induction(T1),external iliac veins blocked(T2)and open external iliac vein(T3),CO(cardiac output),SVR(peripheral vascular resistance),SVV(stroke variability),MAP(mean arterial pressure)and HR(heart rate)values of time points at the end of surgery(T4)were recorded in the two groups.Also,recording intraoperative fluid volume,blood loss,and urine volume as well.And conducting a comparative study between the completion of surgery and 24 h after surgery by documenting intraoperative creatinine clearance(Ccr),blood urea nitrogen(Bun),serum creatinine(Scr)and urine volume.Results:At the time point of T3,the SVR in the D group was significantly lower than that in the E group(P<0.05);The SVR value of T4 in the group N was lower than that in the t1,the SVR values of T3 and T4 were all lower than those in the T1.The differences were statistically significant.The SVV values of T3 and T4 in group D and group N were lower than those of T1,the MAP value of T3 in group D was lower than that of T1,the differences were both statistically significant.Also,at the time point of T4,the HR in the D group was significantly lower than that in the E group(P<0.05);No significant differences in the intraoperative blood transfusion volume,blood loss and the kidney functional indicators at the end of surgery,and 24h after surgery between the two groups.Conclusion(s):The use of norepinephrine(0.03～0.3 ug · kg-1 · min-1)in renal transplantation can maintain the appropriate intraoperative perfusion pressure,improve the peripheral vascular resistance,reduce heart rate,efficiency of elevate the blood pressure is stronger than the dopamine,little effect on cardiac output,compared with dopamine,the effect on postoperative renal function is not statistically difference,0.03～0.3 ug · kg-1 · min-1 dose norepinephrine is safe for kidney transplant patients.