Miller Anestesia

implantable de administración de fármacos. La metadona con fre-

cuencia es útil en pacientes con tolerancia a los opioides que tienen

dolor neuropático debido a su efecto agonista sobre los receptores

mu y su efecto antagonista sobre los receptores

-metil-d-aspar-

tato. Debido a la seguridad, la eficacia y la relativa facilidad de

administración intrarraquídea de los opioides para el control del

dolor intratable debido a enfermedad metastásica, cada vez se uti-

lizan más los sistemas de administración de fármacos intratecales

y epidurales implantables.

Agradecimientos

Los autores agradecen la útil contribución y experiencia de Dan

Paloski, ayudante editorial del Departamento de Anestesiología

General de la Cleveland Clinic, en la preparación de este

manuscrito.

Bibliografía

10. Mann JF: What are the short-term and long-term

consequences of anaemia in CRF patients? Nephrol

Dial Transplant 14:29–36, 1999.

11. Winearls CG: Recombinant human erythropoietin:

10 years of clinical experience. Nephrol Dial Trans-

plant 13:3-8, 1998.

12. Anderson RJ, Gambertoglio JG, Schier RW: Clinical

Use of Drugs in Renal Failure. Springfield, IL,

Charles C Thomas, 1976.

13. Prescot LF: Mechanisms of renal excretion of drugs

(with special reference to drugs used by anesthesio-

logists). Br J Anaesth 44:246, 1972.

14. Davies G, Kingswood C, Street M: Pharmacokinetics

of opioids in renal dysfunction. Clin Pharmacokinet

31:410-422, 1996.

15. Mazoit JX, Sandouk P, Scherrmann JM, Roche A:

Extrahepatic metabolism of morphine occurs in

humans. Clin Pharmacol Ther 48:613-618, 1990.

16. Schochet RB, Murray GB: Neuropsychiatric toxicity

of meperidine. J Intensive Care Med 3:246, 1988.

17. Davis PJ, Stiller RL, Cook DR: Pharmacokinetics of

sufentanil in adolescent patients with chronic renal

failure. Anesth Analg 67:268-271, 1988.

18. Chauvin M, Lebrault C, Levron JC, Duvaldestin P:

Pharmacokinetics of alfentanil in chronic renal

failure. Anesth Analg 66:53-56, 1987.

19. Davison SN: Pain in hemodialysis patients: Preva-

lence, cause, severity, and management. Am J Kidney

Dis 42:1239-1247, 2003.

20. Mazze RI: Metabolism of the inhaled anaesthetics:

Implications of enzyme induction. Br J Anaesth

56:275, 1985.

21. Cousins M, Mazze RI: Methoxyflurane nephrotoxi-

city: A study of dose response in man. JAMA

255:1611, 1973.

22. Mazze RI, Sievenpiper TS, Stevenson J: Renal effects

of enflurane and halothane in patients with abnormal

renal function. Anesthesiology 60:161, 1984.

23. Mazze RI, Cousins MJ, Barr GA: Renal effects and

metabolism of isoflurane in man. Anesthesiology

40:536, 1974.

24. Eger EI II: Stability of I-653 in soda-lime. Anesth

Analg 66:983, 1987.

25. Jones RM, Koblin DD, Cashman JN, et al: Biotrans-

formation and hepato-renal function in volunteers

after exposure to desflurane (I-653). Br J Anaesth

64:482, 1990.

26. Weiskopf RB, Eger EI II, Ionescu P, et al: Desflurane

does not produce hepatic or renal injury in human

volunteers. Anesth Analg 74:570, 1992.

27. Hanaki C, Fujii K, Mono M, Tashima T: Decomposi-

tion of sevoflurane by soda-lime. Hiroshima J Med Sci

36:61, 1987.

28. Kobayashe Y, Ochiai R, Takeda J, et al: Serum and

urinary inorganic fluride levels after prolonged inha-

lation of sevoflurane in man. Anesthesiology 75:A348,

1991.

29. Holaday DA, Smith FR: Clinical characteristics and

biotransformation of sevoflurane in healthy human

volunteers. Anesthesiology 54:100, 1981.

30. Priano LL: Effect of halothane on renal hemodyna-

mics during normovolemia and hemorrhagic hypo-

volemia. Anesthesiology 63:357, 1985.

31. Merin RG, Bernard JM, Doursout MR: Comparison of

the effects of isoflurane and desflurane on cardiovas-

cular dynamics and regional blood flow in the chroni-

cally instrumented dog. Anesthesiology74:568, 1991.

32. Cousins MJ, Greenstein LR, Hitt BA, Mazze RI:

Metabolism and renal effects of enflurane in man.

Anesthesiology 44:44, 1976.

1. Anderson KJ, Kabalin JN, Cadeddu JA: Surgical

anatomy of the retroperitoneum, kidneys, and

ureters.

Wein AJ, Kavoussi LR, Novick AC, Partin

AW, Peters CA (eds): Campbell-Walsh Urology, 9th

ed. Philadelphia, WB Saunders, 2007, pp 3–37.

2. Brooks JD: Anatomy of the lower urinary tract and

male genitalia.

Wein AJ, Kavoussi LR, Novick AC,

Partin AW, Peters CA (eds): Campbell-Walsh Urology,

9th ed. Philadelphia, WB Saunders, 2007, pp 38–77.

3. Hemmings HC Jr: Anesthesia, adjuvant drugs and

the kidney.

Malhotra V (ed): Anesthesia for Renal

and Genitourinary Surgery. New York, McGraw-

Hill, 1996, pp 18.

4. Kassirer JP: Clinical evaluation of kidney function-

glomerular function. N Engl J Med 285:385, 1971.

5. May RC, Mitch WE: The pathophysiology of uremia.

Brenner BM, Rector FC Jr (eds): The Kidney, 5th

ed. Philadelphia, WB Saunders, 1996, p 2148.

6. Bazari H: Approach to the patient with renal

disease.

Goldman L, Ausiello D (eds): Cecil

Textbook of Medicine, 22nd ed. Philadelphia, WB

Saunders, 2004, pp 654–662.

7. Goldman L, Bennett JC (eds): Cecil Textbook of

Medicine, 22nd ed. Philadelphia, WB Saunders,

2004.

8. Elkington JR, Huth EJ, Webster GD Jr, et al: The renal

excretion of hydrogen ion in renal tubular acidosis, I:

Quantitative assessment of the response to ammonium

chloride as an acid load. Am J Med 29:554, 1960.

9. Prough DS, Foreman AS: Anesthesia and the renal

system.

Barash PG, Cullen BF, Stoelting RK (eds):

Clinical Anesthesia, 2nd ed. Philadelphia, JB

Lippincott, 1992, pp 1125–1156.

Anestesia y los sistemas renal y genitourinario

1897

Sección IV

Anestesia por subespecialidades en el adulto

Figura 55-5

Algoritmo escalonado de la Organización Mundial de la Salud para el tratamiento del dolor. AINE, antiinflamatorios no esteroideos.