Анестезия при нефрэктомии у 20-месячной пациентки с гигантской нефробластомой: описание клинического случая (Н.В. Матинян, А.И. Салтанов, Л.А. Мартынов, А.П. Казанцев)

A case of anesthesia management for nephrectomy in 20-month-old patient with a giant Wilms tumor is reported. The complexity of anesthesia was determined by the size of tumor, increased intra-abdominal pressure, respiratory deficiency, hypercoagulation and tumor intoxication. However, intraoperative epidural analgesia: continuous infusion of mixture of local anesthetic, opioid analgesic and epinephrine, provided reliable protection against surgical stress response, granted hemodynamic stability and fast recovery in the earliest postoperative period. Pneumoprotective ventilation strategy excluded hypoxic disorders of organs and tissues in the intra- and postoperative period, with an eye to inflammatory changes and hypoventilation in lungs, and keeping in mind the huge size of the tumor. «Harvard standard» monitoring, bispectral index monitoring, capillary blood gas and coagulation intraoperative tests, as well as transesophageal doppler provided adequate infusion-transfusion therapy and rapid recovery in the postoperative period. ( For citation: Matinyan N.V., Saltanov A.I., Martynov L.A., Kazantsev A.P. Anesthesia Management of a 20-month-old Patient with Giant Unilateral Wilms Tumor: Case Report. Onkopediatria. 2015; 2 (1): 69 – 72).