AANA journal
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One of the very real complications possible in the use of local anesthetic agents is a relative overdose of the drug, resulting in an inordinate and potentially dangerous serum level. Even when using strict and careful technique, problems can occur. The reactions cited in the aforementioned cases were most likely the result of the accidental intravenous injection of a local anesthetic agent. ⋯ Nevertheless, local anesthetics are potentially toxic and their use should be approached with knowledge of and a healthy respect for their associated complications. It should also be remembered that virtually all local anesthetic toxic reactions are preventable and treatable. Their occurrence need not necessarily result in a poor outcome.
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The morbidity of transplantation is considerably decreased and the mortality of cadaver transplants from sepsis has been reduced to 5% or less as the result of excessive immunosuppression therapy and reduced infection. There is uniform agreement that renal transplantation has the best potential for restoring a patient with end-stage renal failure to his normal state of physical, mental, and psycho-social health. Both regional and general anesthesia have their drawbacks in kidney transplants. However, by combining the practice of safe anesthesia, improved surgical techniques, and better knowledge of the immunosuppressant drugs, there is near perfect control over the possibility of kidney rejection in kidney transplantation between identical twins.