Anesthetic Management and Postoperative Pain Control in a Pediatric Patient Undergoing Unilateral Radical Nephrectomy Associated with Cavectomy: Case Report

ABSTRACT

Introduction:  Wilms tumor is considered the most common malignant renal tumor in childhood, corresponding to approximately 5% of all neoplasms in pediatric patients. The anesthetic strategy and surgical approach are decisive parts of the treatment and directly influence the patients’ prognosis. The objective of this study is to describe the anesthetic management and postoperative pain control in a pediatric patient undergoing unilateral radical nephrectomy associated with cavectomy.

Case report:  Pediatric patient undergoing radical nephrectomy associated with cavectomy. As an anesthetic strategy, multimodal associated with epidural analgesia was performed to control pain. Invasive monitoring of hemodynamic variables was performed and thromboelastogram was used to evaluate coagulation. Postoperative pain was assessed using the Children's and Infants’ Postoperative Pain Scale (CHIPPS).

Conclusion:  Multimodal anesthesia and point-of-care examinations contribute to improving care in major pediatric oncological surgeries. CHIPPS is a validated scale that allows the effective assessment of postoperative pain in this population.

Key words:
Wilms Tumor/surgery; Nephrectomy; Anesthetics/administration & dosage; Pain Management/methods; Child