Intrapleural analgesia in a child with a mediastinal tumour

Abstract

A case is presented of an eight-year-old child with a mediastinal tumour, who had developed acute renal failure following the institution of steroid therapy. Intrapleural analgesia was successfully used for the insertion of a peritoneal dialysis catheter so that the considerable risks of general anaesthesia were avoided. Subsequent dialysis allowed chemotherapy to commence and, as a result of the shrinkage in tumour size, general anaesthesia was administered safely two days later. The purpose of this report is to highlight the use of intrapleural analgesia in children as an alternative to general anaesthesia, when the latter is contraindicated. The mechanism of action of intra-pleural analgesia and the risks of anaesthesia in the presence of a mediastinal tumour are discussed. © 1994 Canadian Anaesthesiologists.