[Successful Postoperative Management of a Pediatric Patient with Renal Failure by Ultrasound-guided Transversus Abdominis Plane and Rectus Sheath Block].

ABSTRACT

We report the successful postoperative pain man- agement of a pediatric patient with end-stage renal failure by ultrasound-guided peripheral nerve block following peritoneal dialysis catheter surgery. A 2-year-old boy with kidney hypoplasia was scheduled for peritoneal dialysis catheter implantation under gen- eral anesthesia. Anesthesia was induced with nitrous oxide and sevoflurane in a slow incremental manner. Airway management was performed with i-gelo to minimize stress and to protect the cervical spine. Maintenance of anesthesia was achieved with sevoflu- rane and remifentanil. For postoperative analgesia, opi- oids were not used in order to avoid respiratory sup- pression or CO2 accumulation. Recovery from anesthe- sia was uneventful and the boy did not experience pain until the next morning.