Anesthetic management of a child undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for recurrent embryonal rhabdomyosarcoma: A case report

ABSTRACT

This case report explains the perioperative anesthetic management of a 7-year-old child experiencing recurrent abdominopelvic embryonal rhabdomyosarcoma. The patient is scheduled for cytoreductive surgery as well as hyperthermic intraperitoneal chemotherapy. This case was regarded as challenging due to the chemotherapy and radiotherapy executed previously, compromise in terms of nutrition, anticipated fluid movements, thermal stress and scheduled postoperative intensive care. Preoperative echocardiography affirmed the preserved biventricular function. Anesthesia utilized balanced usual anesthesia, invasive monitoring of the arterial pressure, access to the central venous, monitoring of cardiac output, esophageal temperature with thoracic epidural analgesia. Intraoperative priorities included hemodynamic stability, thermal control, electrolyte with surveillance of acid and base, readiness of blood products, and multimodal analgesia. The child was shifted intubated to the pediatric intensive care unit and extubated post-24 hours. This case underscores the value of systematic planning, advanced phenomenon of monitoring and multimodal cooperation in rare pediatric CRS-HIPEC anesthesia.