Article Text

Download PDFPDF

#34666 Case report: Ablation of renal tumour in high bmi patient under single shot paravertebral and remifentanil
  1. David Lorigan1 and
  2. Suresh Kuthanur-Natarajan2
  1. 1Dublin, Ireland
  2. 2Anaesthesiology, Saint James Hospital, Dublin, Ireland


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Background and Aims Managing patients with multiple comorbidities is an increasingly common requirement of anaesthesiologists. This is compounded by the increasing demand for anaesthesia to be provided outside of the operating theatre. The role of regional anaesthesia and its use in avoiding the general physiological changes associated with general anaesthesia is becoming increasingly apparent.

Methods Our patient is a 60 year old male presenting for radiofrequency ablation of a renal tumour. His medical history was relevant for tuberculosis involving his lungs and pericardium for which he had undergone a right lower lobectomy and pericardiectomy, and Ulcerative Colitis for which he had undergone a subtotal colectomy. His comorbidities included Chronic Obstructive Pulmonary Disease for which he was on 6 litres/minute of portable oxygen, obstructive sleep apnoea requiring CPAP, recurrent chest infections, Atrial fibrillation on Rivaroxaban, Liver Cirrhosis Childs Pugh A, Grade 1 Obesity, Type 2 diabetes, Gout, steroid induced myopathy.

Results We report the use of an ultrasound guided paravertebral block in conjunction with monitored sedation using remifentanil to facilitate radiofrequency ablation of a low grade clear cell renal tumour. The procedure was tolerated well with satisfactory ablation of the tumor. Mr. EL was discharged the day after his procedure for follow up imaging in 4 months.

Conclusions The use of a regional technique allowed us to avoid the complications of general anaesthesia in this high-risk gentleman, while facilitating the ablation of his renal tumor. Paravertebral blocks serve an increasingly important role in facilitating ablation of solid organ tumours, including lung, liver and kidney, in our institution.

  • Paravertebral
  • renal tumour
  • ablation
  • remote anaesthesia

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.