Abstract

ALBORNOZ PARDO, Alfonso Ernesto et al. Anesthetic and surgical considerations for staged bilateral nephrectomies in a pediatric patient: A case report. Rev. colomb. anestesiol. [online]. 2022, vol.50, n.3, e500.  Epub July 28, 2022. ISSN 0120-3347.  https://doi.org/10.5554/22562087.e1009.

We present a 9-year-old patient with end-stage renal disease, on peritoneal dialysis, who underwent a staged prone retroperitoneoscopic bilateral nephrectomy. Bilateral nephrectomy was indicated in preparation for renal transplant in the context of genetic predisposition malignancy when immunosuppressed. The two mirror-image surgeries enable the comparison of the anesthetic management and outcomes in a single patient. Features of interest to anesthesiologists include approach to a child with chronic kidney disease, different requirements for intraoperative antihypertensives; pain management strategies, including a comparison of erector spinae plane block with and without adjunct dexmedetomidine; anesthetic management of retroperitoneoscopic pediatric surgery and the first description of using a Foley bag attached to a peritoneal dialysis catheter to aid in diagnosis and repair of posterior peritoneal cavity entry.

Keywords : Pediatric anesthesia; Kidney failure, Chronic; Erector spinae plane block; Hypertension, renal; Nephrectomy; Laparoscopy; Case report.

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