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Published on: March 12, 2020

[Thoracic epidural analgesia for a thrombocytopenic child]

S Roullet1, F Lavrand, S Français

  • 1Département d'anesthésie-réanimation-IV, hôpital Pellegrin-Enfants, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.

Annales Francaises D'Anesthesie Et De Reanimation
|August 18, 2006
PubMed

Insights

Managing chronic pain post-surgery is difficult. Thoracic epidural analgesia was successful in a thrombocytopenic child after platelet transfusion, despite central thrombocytopenia being a relative contraindication.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Pain Management

Background:

  • Effective postoperative analgesia for chronic pain patients presents challenges.
  • Locoregional anesthesia is preferred unless contraindicated.
  • Thrombocytopenia poses a significant risk for regional anesthesia procedures.

Observation:

  • A pediatric patient with central thrombocytopenia required thoracotomy.
  • Previous surgeries indicated a failure of intravenous analgesia.
  • Thoracic epidural anesthesia was considered despite the patient's low platelet count.

Findings:

  • The child received platelet transfusions to increase platelet count.
  • Thoracic epidural analgesia was successfully administered post-surgery.
  • Central thrombocytopenia was managed as a relative contraindication, not an absolute one.

Implications:

  • This case demonstrates the feasibility of thoracic epidural analgesia in select thrombocytopenic pediatric patients.
  • Careful management, including platelet transfusion, can mitigate risks associated with regional anesthesia in thrombocytopenia.
  • Findings support considering thoracic epidural anesthesia in specific pediatric cases with thrombocytopenia when benefits outweigh risks.

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