Perioperative Management of Chronic Kidney Disease Patients with Bowel Perforation

Hafizh Nur Santoso, Dykall Naf’an Dzikri
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Abstract

Background: Anesthesia management applied during surgery in patients with chronic kidney disease (CKD) is different from ordinary anesthetic management. It is known that currently, there are not many case reports discussing anesthetic management in patients with CKD.Case Illustration: A 70-year-old patient with abdominal colic et causa abdominal perforation complained of abdominal pain accompanied by heavy bowel movements and flatus throughout the abdominal area. The patient was anesthetized by regional anesthesia with local agent bupivacaine and treated with laparotomy. Bupivacaine is the first local anesthetic drug with an acceptable onset of action, long duration of action, and a tendency for the sensory block to be greater than its motor block.Conclusion: This case report explains the novelty of anesthetic management of CKD patients undergoing exploratory laparotomy surgery using the reported patient cases. Operations in patients with CKD are preferable to regional anesthesia.
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慢性肾病伴肠穿孔患者的围手术期处理
背景:慢性肾脏疾病(CKD)患者手术麻醉管理不同于普通麻醉管理。据了解,目前讨论CKD患者麻醉管理的病例报告并不多。病例说明:一名70岁的腹部绞痛患者,腹部穿孔,主诉腹痛并伴有大量排便和整个腹部放屁。患者行布比卡因局部麻醉,开腹手术治疗。布比卡因是第一种具有可接受的起效、作用持续时间长、感觉阻滞大于运动阻滞的倾向的局部麻醉药物。结论:本病例报告解释了CKD患者剖腹探查手术麻醉管理的新颖性。CKD患者手术优于区域麻醉。
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