{
  "abstract": "Application for ESRA Abstract Prizes : I apply as an Anesthesiologist (Aged 35 years old or less)Background and Aims Regional anesthesia is vital in patients with liver transplantation undergoing orthopedic surgery. With the increased availability of ultrasound machines as well as the continued development of enhanced recovery after surgery (ERAS) protocols, regional anesthesia has become an essential component of providing analgesia and minimizing opioid use perioperatively. Many centers currently utilize peripheral and neuraxial blocks during transplantation surgery.Methods 64-year-old male patient with history of liver transplantation 10 years ago due to hepatitis B infection of unknown cause on immunosuppression medications of prograf (tacrolimus) 1 mg, HEPAVIR 0.5 mg with osteoporosis. Pre anesthesia evaluation with cleared continuation of his liver medications and lab results were within normal range. Spinal anesthesia with adductor canal catheter and IPACK was offered for the patient.no hypotension or sedation was given to patient. He received bupivacaine 0.5% 2 ml spinal anesthesia, Bup 0.5% 15 ml in adductor catheter and Bup 0.25% 15 m for IPACK. Along with local infiltration by surgeon of clonidine 0.15 mg, ketorolac 30 mg, Rop 0.5% 20 ml. Duration of surgery was 3 hours without any complications.Results first day Postoperatively, he developed an increase of his liver enzymes (24 hours 4x higher, 33 hours postop 40–55 X higher), treated aggressively with methylprednisolone 500 mg IV, next day liver enzymes decreased to half. The patient improved and remained stable and left hospital after 5 days with normal liver function test.Conclusions Allograft rejection may occur at any time during the post-transplant period, especially when discontinuing the use of immunosuppressants. Chronic rejection is the most significant medical obstacle. The increasing prevalence of previously transplanted patients makes it likely that every anesthesiologist will care for patients with transplant-related surgery in the future. Local, regional, or general anesthesia can be safely delivered to transplant recipients and a successful anesthetic and perioperative management can be provided.",
  "authors": [
    {
      "affiliations": [
        "Riyadh, Saudi Arabia"
      ],
      "name": "Aboud AlJabari"
    }
  ],
  "title": "P089 Regional anesthesia of TKA in patient with liver transplantation",
  "uid": "d7789222-92f4-5c45-9715-d0e921e4003a"
}