Blanco Vargas D, Pintanel Rius T, Ortiz Soler M, Castellví A, Preciado M J, González Tadeo M
Servicios de Anestesiología y Reanimación y Cirugía Pediátrica, Hospital de Badalona Germans Trias i Pujol, Barcelona.
Rev Esp Anestesiol Reanim. 1991 Mar-Apr;38(2):112-4.
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.
我们报告了一种麻醉技术，用于控制一名25个月大、体重10公斤的I期肾母细胞瘤患儿的高血压。在手术切除前4周，他接受了放线菌素D和长春新碱治疗，因长春新碱导致抗利尿激素分泌不足。采用全身麻醉，使用阿托品、硫喷妥钠和阿曲库铵作为肌肉松弛剂。术中未给予全身麻醉性镇痛药。通过L3-L4穿刺将导管置入硬膜外间隙，导管末端位于L1。在给予两次3ml的0.3%不含肾上腺素的布比卡因之前，用碘海醇对导管末端进行放射学定位，术中血压维持正常。结论是，联合表面全身麻醉技术与持续硬膜外阻滞，可有效控制肾母细胞瘤患者的高血压。
