Pain management in children undergoing rhabdoid tumor resection.
Case report

Flavia Claro da Silva; Vanderson Carvalho Neri; Rachel Motyl Gutman; Matheus Cabral Raulino de Oliveira

doi:10.63231/2595-0118.20250026-en

Case Report

Pain management in children undergoing rhabdoid tumor resection. Case report

Manejo da dor pós-operatória em criança submetida a ressecção de tumor rabdoide. Relato de caso

Flavia Claro da Silva; Vanderson Carvalho Neri; Rachel Motyl Gutman; Matheus Cabral Raulino de Oliveira

http://dx.doi.org/10.63231/2595-0118.20250026-en BrJP, vol.8, e20250026, 2025

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Abstract

BACKGROUND AND OBJECTIVES: Rhabdoid tumors are rare aggressive tumors and affect specially the young population, with a predominance in children under 4 years of age. Literature data define them as a disease of high malignancy and grim prognosis. The proper control and adequate approach to postoperative pain in children should always be a priority in the anesthetic-surgical planning.

CASE REPORT: A child undergoing general anesthesia, associated with multimodal analgesia technique, epidural block, and Transversus Abdominis Plane block (TAP Block) for rhabdoid tumor surgical resection in the lower limb. The chosen anesthetic technique aimed to achieve good pain control in the postoperative period, in major oncologic surgery approach. The instrument used for measuring pain scores was the Children and Infants Postoperative Pain Scale (CHIPPS).

CONCLUSION: Multimodal anesthesia associated with epidural technique and peripheral nerve block seems adequate for postoperative pain control in major cancer surgeries. Adequate management and control of painful complaints can be beneficial not only in the short term and in the postoperative period but can also have beneficial impacts in the adulthood of pediatric cancer patients who underwent surgical treatment.

Keywords

Anesthesia; Child; Pain; Cancer

Resumo

JUSTIFICATIVA E OBJETIVOS: Os tumores rabdoides são tumores agressivos raros, acometendo principalmente a população jovem, com predominância em crianças menores de 4 anos de idade. Dados da literatura definem a doença como de alta malignidade e prognóstico desalentador. O bom controle e adequada abordagem da dor pós-operatória na criança deve ser sempre prioridade no planejamento anestésico-cirúrgico.

RELATO DO CASO: Criança submetida à anestesia geral, associada à técnica de analgesia multimodal, bloqueio peridural e bloqueio do plano transverso do abdômen (TAP Block) para ressecção de tumor rabdoide em membro inferior. A técnica anestésica utilizada foi escolhida visando um bom controle de dor no período pós-operatório para uma abordagem cirúrgica de grande porte. O instrumento utilizado para a mensuração da queixa álgica foi a escala Children’s and Infants’ Postoperative Pain Scale (CHIPPS).

CONCLUSÃO: A anestesia multimodal associada à técnica peridural e ao bloqueio de nervo periférico parece ser adequada para o controle de dor pós-operatória em cirurgias oncológicas de grande porte. O adequado manejo e controle da queixa álgica pode ser benéfico não somente a curto prazo e no período pós-operatório, como também pode gerar impactos positivos na vida adulta dos pacientes pediátricos com câncer submetidos a tratamento cirúrgico.

Palavras-chave

Anestesia; Criança; Dor; Câncer

References

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Submitted date:
08/19/2024

Accepted date:
04/07/2025