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Intrapleural analgesia in a child with a mediastinal tumour
1University Department Of Surgical and Anaesthetic Sciences, Royal Hallamshire Hospital, Sheffield, England.
Insights
This case study highlights intrapleural analgesia as a safe alternative to general anesthesia in children with mediastinal tumors. It enabled timely dialysis and chemotherapy, improving patient outcomes.
Area of Science:
- Pediatric Oncology
- Anesthesiology
- Nephrology
Background:
- A pediatric patient with a mediastinal tumor developed acute renal failure after steroid therapy.
- General anesthesia posed significant risks due to the mediastinal tumor.
- The patient required peritoneal dialysis for renal support.
Abstract:
A case is presented of an eight-year-old child with a mediastinal tumour, who had developed acute renal failure following the institution of steroid therapy. Intrapleural analgesia was successfully used for the insertion of a peritoneal dialysis catheter so that the considerable risks of general anaesthesia were avoided. Subsequent dialysis allowed chemotherapy to commence and, as a result of the shrinkage in tumour size, general anaesthesia was administered safely two days later. The purpose of this report is to highlight the use of intrapleural analgesia in children as an alternative to general anaesthesia, when the latter is contraindicated. The mechanism of action of intrapleural analgesia and the risks of anaesthesia in the presence of a mediastinal tumour are discussed.