[Usefulness of peridural anesthesia in surgery on a patient with Wilms' tumor and arterial hypertension].
We report an anesthetic technique to control hypertension in a Wilms' tumor in stage I in a 25-month-old child weighing 10 kg. He was treated with actinomycin D and vincristine during 4 weeks before surgical resection, developing inadequate ADH secretion due to vincristine. General anesthesia was used, with atropine, thiopental and atracurium as muscular relaxant. Systemic intraoperative anesthesia with narcotics was not given. A catheter was placed in the epidural space, with entrance through L3-L4 and its extreme in L1. Radiological control of the distal end of the catheter was carried out with iohexol before the administration of two 0.3% bupivacaine doses without adrenaline of 3 ml each, and intraoperative normal blood pressure was achieved. It was concluded that combined superficial general anesthesia techniques, associated with continuous epidural blockade, can be useful to control hypertension in Wilms' tumor.
Blanco Vargas
D
D
Servicios de Anestesiología y Reanimación y Cirugía Pediátrica, Hospital de Badalona Germans Trias i Pujol, Barcelona.
Pintanel Rius
T
T
Ortiz Soler
M
M
Castellví
A
A
Preciado
M J
MJ
González Tadeo
M
M
D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D002675:Child, Preschool; D006801:Humans; D006977:Hypertension, Renal / Q000209:etiology; D007680:Kidney Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D009396:Wilms Tumor / Q000150:complications / Q000601:surgery*
Utilidad de la anestesia peridural en la cirugía de un paciente con tumor de Wilms e hipertensión arterial.