ANAESTHETIC MANAGEMENT OF A PATIENT WITH CARDIAC PACEMAKER FOR RENAL TRANSPLANT

Dr. Kinjal Prajapati; Dr. Shalini Rathod

Volume : VIII, Issue : XI, November - 2019

ANAESTHETIC MANAGEMENT OF A PATIENT WITH CARDIAC PACEMAKER FOR RENAL TRANSPLANT

Dr. Kinjal Prajapati, Dr. Shalini Rathod

Abstract :

Patients with permanent pacemaker posted for non cardiac surgery pose challenges for modern–day anaesthesiology. The important considerations in this regard are pacemaker dependency, prior programming to asynchronous mode, electrocautery, perioperative interference leading to pacemaker failure and hemodynamic compromise. We report successful anaesthetic management of a patient of chronic renal failure with permanent pacemaker in situ who underwent renal transplant under general anaesthesia. Case report: A 40 year old male patient weighing 55kilgrams with diagnosis of chronic renal failure posted for open right renal transplant under general anaesthesia. Patient was k/c/o chronic hypertension since 2013 and hypothyroidism since 2014 Past medical history revealed complete heart block, for which permanent pacemaker was implanted 6 years ago. Conclusion: Open renal transplant in patients with pacemakers is possible but requires a multidisciplinary approach to care. During surgery, bipolar electrocautery should be used to reduce electromagnetic interference and the grounding pad should be placed as far away from the pacemaker as possible.