ANH involving the removal of 2 to 3 units (450 mL each) may be useful in patients with anticipated blood loss exceeding 50 percent of estimated blood volume, high initial hematocrit, and a capacity to tolerate dilution-induced anemia.

Mediastinal masses naturally pose a certain degree of challenge to anesthesiologists. Specifically, incidental mediastinal masses discovered in an acute setting, such as during a trauma, prove to be even more challenging. Our case report describes anesthetic considerations and acute pain management in a trauma patient with a large incidental anterior mediastinal mass in need of an urgent orthopedic intervention. The types of mediastinal masses, the risks/benefits of regional versus neuraxial techniques, and the safety concerns for general anesthesia are also discussed.