Anesthesia and Postoperative Pain Management Associated with the Neurophysiological Monitoring Technique in Pediatric Oncology: Case Report
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n4.4023Keywords:
neuroblastoma, pain, postoperative, surgical oncologyAbstract
Introduction: Neuroblastoma is the most common non-central nervous system in childhood. From six to ten million children are identified with this disease annually. Surgical treatment, which involves tumor resectability, is a decisive factor in the therapeutic strategy of these patients, with clear influence on disease’s prognosis. Case report: Nursling submitted to general anesthesia and peripheral nerve block for neuroblastoma surgical resection with intraoperative neurophysiological monitoring (IONM) and spinal erector plane block (ESP), associated with the multimodal analgesia technique for pain control. The postoperative pain was evaluated using the Children’s and Infants’ Postoperative Pain Scale (CHIPPS). Conclusion: IONM has established itself as an important tool to monitor neurological functions during surgical approaches with involvement of the central nervous system, in order to avoid permanent damage to important structures. The interaction and communication of the entire team are of paramount importance in the postoperative results.
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La Quaglia MP. State of the art in oncology: high risk neuroblastoma, alveolar rhabdomyosarcoma, desmoplastic small round cell tumour, and post-text 3 and 4 hepatoblastoma. J Pediatri Surg. 2014;49(2):233-40. doi: https://doi.org/10.1016/j.jpedsurg.2013.11.029
Crocoli A, Martucci C, Randi F, et al. Intraoperative neuromonitoring for pediatric pelvic tumors. Front Pediatrics. 2022;30(10):1-6. doi: https://doi.org/10.3389/fped.2022.949037
Beverly A, Kaye AD, Ljungqvist O, et al. Essential elements of multimodal analgesia in enhanced recovery after surgery (ERAS) guidelines. Anesthesiol Clin. 2017;35(Supl 1):S40-5. doi: https://doi.org/10.1016/j.anclin.2017.01.018
Gritsenko K, Khelemsky Y, Kaye AD, et al. Multimodal therapy in perioperative analgesia. Best Pract Res Clin Anaesthesiol. 2014;28(1):59-79. doi: https://doi.org/10.1016/j.bpa.2014.03.001
Conselho Nacional de Saúde (BR). Resolução n° 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção I:59.
Baker DL, Schmidt ML, Cohn SL, et al. Outcome after reduced chemotherapy for intermediate-risk neuroblastoma. New Eng J Med 2010;363:1313-23. doi: https://doi.org/10.1056/NEJMoa1001527
Instituto Nacional de Câncer. Imagens radiológicas. 2022 nov 16. Repositório Institucional Ninho [Internet]. [acesso 2023 fev 20]. Disponível em: https://ninho.inca.gov.br/jspui/
American Society of Anesthesiologists. [internet]. Washington, DC: ASA; 2014. Asa Physycal Status Classification System. 2014 out 15. [Atualizado 2020 dez 13, acesso 2023 fev 20]. Disponível em: https://www.asahq.org/standards-and-guidelines/asa-physical-status-classification-system
Alves MM, Carvalho PRA, Wangner MB, et al. Cross-validation of the children's and infants' postoperative pain scale in brazilian children. Pain Practice. 2008;8(3):171-6. doi: https://doi.org/10.1111/j.1533-2500.2008.00192.x
Simon MV. Intaroperative neurophysiology: a comprehensive guide to monitoring and mapping. 2. ed. Nova York: Demos Medical Publishing; 2009.
Warmann SW, Lag S, Fideler F, et al. Perioperative epidural analgesia in children undergoing major abdominal tumor surgery-a single center experience. J Pediatr Surg. 2014;49(4):551-5. doi: https://doi.org/10.1016/j.jpedsurg.2013.10.025
Kain ZN, Shamberg RS, Holzman RS. Anesthesic management of children with neuroblastoma. J Clin Anest. 1993;5(6):486-91. doi: https://doi.org/10.1016/0952-8180(93)90066-n
Chou R. Gordon DB, Leon-Casasola OA, et al. Management of postoperative pain: a clinical practice guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131-57. doi: https://doi.org/10.1016/j.jpain.2015.12.008
Silva FC, Santos Thuler LC, Leon-Casasola AO. Validity and reliability of two pain assessment tools in brazilian children and adolescents. J Clinical Nursing. 2011;20(13-14):1842-8. doi: https://doi.org/10.1111/j.1365-2702.2010.03662.x
Forero M, Adhikary SD, Lopez H, et al. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):6217. doi: https://doi.org/10.1097/AAP.0000000000000451
Tognon C, Rebecca Pulvirenti R, Federica Fati F, et al. Anesthesia in children with neuroblastoma, perioperative and operative management. Children (Basel). 2021;8(5):395. doi: https://doi.org/10.3390/children8050395
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