A Comparative Study on the Effect of Lidocaine and Furosemide on Urinary Output and Graft Function after Renal Transplantation

Abstract

<p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Purpose:</strong> Renal transplantation is an ideal treatment for patients with chronic renal failure. It was demonstrated that despite the adhesion to surgical and anesthetic principles, urinary output is not satisfactory after transplantation. It seems that microvascular spasm of renal vasculature is responsible for this phenomenon. We designed a study to investigate whether lidocaine injection into renal artery can relieve vasospasm and subsequently improve output and graft function better than furosemide. </span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Materials and Methods:</strong> In a randomized clinical trial, from July 2002 to November 2003, 100 consecutive patients who were referred to our center for kidney transplantation were recruited in this study. After obtaining written informed consent, they were divided blindly into two groups. In group 1, lidocaine was injected into renal artery, before arterial anastomosis, and group 2 received furosemide as the conventional intervention. Urine volume within 1, 4, and 24 postoperative hours and serum creatinine levels in the first three weeks were recorded and compared between the two groups.<span style="mso-spacerun: yes;"> </span></span></span></p><p class="MsoNormal" style="margin: 0cm 0cm 0pt; mso-pagination: none;"><span style="font-size: small;"><span style="font-family: Times New Roman;"><strong>Results:</strong> Urine volumes at 1, 4, and 24 hours after transplantation were higher significantly in lidocaine group (P < 0.001). Serum creatinine levels were lower significantly in the first postoperative day and also 21 days after transplantation in group 1 (P < 0.001). </span></span></p><strong><span style="font-size: 12pt; font-family: ">Conclusion:</span></strong><span style="font-size: 12pt; font-family: "> Comparing to furosemide, it seems that lidocaine can cause a more effective vasodilation in renal arteries of kidney allograft, resulting in a better diuresis. This may have a role in the betterment of graft function.</span>