title: Intrapleural analgesia in a child with a mediastinal tumour.
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.
authors.affiliation: University Department Of Surgical and Anaesthetic Sciences, Royal Hallamshire Hospital, Sheffield, England.
authors.forename: C F
authors.initials: CF
authors.lastname: Swinhoe
authors.forename: N H
authors.initials: NH
authors.lastname: Pereira
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy*; D000698:Analgesia / Q000379:methods*; D000772:Anesthesia, Local / Q000379:methods*; D015505:Chest Tubes; D002648:Child; D003131:Combined Modality Therapy; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008479:Mediastinal Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D010530:Peritoneal Dialysis / Q000295:instrumentation; D010994:Pleura; D016066:Pleural Effusion, Malignant / Q000628:therapy; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014750:Vincristine