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Objective <p>To evaluate the feasibility and benefits of tubeless anesthesia (TA), using a laryngeal mask airway instead of endotracheal intubation (ETT), in renal transplantation, aligning with tubeless surgery principles.</p> Methods <p>A single-center, retrospective matched-cohort study compared perioperative outcomes and 90-day graft function between TA and ETT in kidney transplantation. 52 adult recipients (26 TA, 26 ETT) operated between July-December 2024 were included. Groups were balanced for age, BMI, ASA classification, and dialysis duration. The Mann-Whitney U test and T test (SPSS 22.0) were used to analyze the outcome indicators: intraoperative anesthetic management, hemodynamics, recovery parameters, and graft function.</p> Results <p>The TA group required significantly lower median doses of cisatracurium (12.6&#xa0;mg vs. 26.1&#xa0;mg; <i>p</i> &lt; 0.001) and sufentanil (22.3&#xa0;µg vs. 28.7&#xa0;µg; <i>p</i> = 0.026). Operative times were similar (211.5&#xa0;min vs. 200.8&#xa0;min; <i>p</i> = 0.475). Vasoactive agent use was lower in the TA group (53.8% vs. 73.1%; <i>p</i> = 0.211), with fewer requiring dual agents (3.8% vs. 15.4%). TA patients exhibited faster awakening (recovery time: 18.5&#xa0;min vs. 34.4&#xa0;min; <i>p</i> &lt; 0.001) and fewer airway complications (7.7% vs. 26.9%; <i>p</i> = 0.070). At 90 days, the TA group had significantly lower serum creatinine (105.6 µmol/L vs. 142.6 µmol/L; <i>p</i> = 0.015). Delayed graft function (15.4% vs. 11.5%; <i>p</i> = 1.000) and early postoperative renal function did not differ significantly.</p> Conclusion <p>Tubeless anesthesia offers perioperative advantages and early graft function benefits in renal transplantation, reducing opioid/muscle relaxant requirements and accelerating recovery. Prospective large-scale studies are warranted to confirm its role in optimizing transplant outcomes.</p> Trial registration <p>This study is a retrospective study.</p>

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Improving renal transplant outcomes through the tubeless anesthesia technique in renal transplantation: a retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月20日

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  • Chuanbao Chen,
  • Jingfeng Ou,
  • Guanyi Wu,
  • Hui Liu,
  • Hanyu Yang,
  • Shaojie Fu,
  • Zhihong Ran,
  • Junbiao Xie,
  • Xin Xu,
  • Jianxing He,
  • Chao Yang,
  • Xiaoyou Liu

摘要

Objective

To evaluate the feasibility and benefits of tubeless anesthesia (TA), using a laryngeal mask airway instead of endotracheal intubation (ETT), in renal transplantation, aligning with tubeless surgery principles.

Methods

A single-center, retrospective matched-cohort study compared perioperative outcomes and 90-day graft function between TA and ETT in kidney transplantation. 52 adult recipients (26 TA, 26 ETT) operated between July-December 2024 were included. Groups were balanced for age, BMI, ASA classification, and dialysis duration. The Mann-Whitney U test and T test (SPSS 22.0) were used to analyze the outcome indicators: intraoperative anesthetic management, hemodynamics, recovery parameters, and graft function.

Results

The TA group required significantly lower median doses of cisatracurium (12.6 mg vs. 26.1 mg; p < 0.001) and sufentanil (22.3 µg vs. 28.7 µg; p = 0.026). Operative times were similar (211.5 min vs. 200.8 min; p = 0.475). Vasoactive agent use was lower in the TA group (53.8% vs. 73.1%; p = 0.211), with fewer requiring dual agents (3.8% vs. 15.4%). TA patients exhibited faster awakening (recovery time: 18.5 min vs. 34.4 min; p < 0.001) and fewer airway complications (7.7% vs. 26.9%; p = 0.070). At 90 days, the TA group had significantly lower serum creatinine (105.6 µmol/L vs. 142.6 µmol/L; p = 0.015). Delayed graft function (15.4% vs. 11.5%; p = 1.000) and early postoperative renal function did not differ significantly.

Conclusion

Tubeless anesthesia offers perioperative advantages and early graft function benefits in renal transplantation, reducing opioid/muscle relaxant requirements and accelerating recovery. Prospective large-scale studies are warranted to confirm its role in optimizing transplant outcomes.

Trial registration

This study is a retrospective study.