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Case Studies | Medical Science | Indonesia | Volume 11 Issue 10, October 2022 | Rating: 4.7 / 10
Anesthesia Considerations in Pediatrics with Wilms' Tumor: A Case Report
Marthen Luther King Elmas | Cynthia Dewi Sinardja [2]
Abstract: Introduction: Wilms' tumor is the most common kidney malignancy in children and overall is the fourth most common malignancy in children. Case report: We reported acase of five years old male patient with a chief complaint of a lump in the right abdomen accompanied by bloating, and nausea and fever. Abdominal CT scan showed a large mass in the right kidney. Patients were planned to underwent radical nephrectomy with GA-OTT. He was given premedication such as Midazolam 1 mg IV, Ketamine 10 mg IV and Fentanyl 25 mcg. He was induced with Propofol titration. For maintenance, a combination of O2: Compressed air: sevoflurane was used. The operation lasted for one hour 45 minutes. During the operation, hemodynamic fluctuations occurred with HR 90-148 x/minute and BP 88-114/51-60mmHg. He was given analgesics such as Fentanyl 75 mcg in 24 hours with a syringe pump and Paracetamol 150 mg every 8 hours IV. He was then admitted to the PICU for four days and was discharged in stable condition. Discussion: The effect of the tumor on the patient's body can have a major impact on the pattern of anesthesia such as the duration of the operation, bleeding, thermoregulation disorders, fluid disorders, and even hemodynamics. Understanding and alertness to the potential occurrence of complications in surgery and after surgery is one of the factors in the successful management of Wilms' tumor. Conclusion: Anesthesia considerations in Wilms tumor surgery lie in the size of the abdominal mass because it can affect the duration of the operation, fluid disturbances, significant bleeding, thermoregulation disorders and suppression of the inferior vena cava.
Keywords: oncology, tumorWilms', pediatrics, anesthesiology
Edition: Volume 11 Issue 10, October 2022,
Pages: 986 - 989