A1079 Anesthetic Management of Mediastinal Masses Revisited

Anaesthesia for a Patient with a Mediastinal Mass Presenting with Acute Stridor

“…Tracheobronchial tree obstruction tends to worsen during general anaesthesia 1,3,11 . Decreased chest wall tone due to the action of inhalational agents and muscle relaxants, cephalad displacement of the dome of the diaphragm and loss of the distending forces of inspiration lead to a reduction in pulmonary compliance and airway diameter and a decrease in thoracic volume limiting the available space for the trachea relative to the tumour 1,12 .…”

“…The use of awake fibreoptic intubation has a number of advantages 1,11,13,16 . We used no sedation and avoided agents that might cause respiratory depression, thereby ensuring the maintenance of spontaneous respiration and causing minimal changes in the dynamic forces maintaining tracheal patency.…”

Anaesthetic management of an infant with anterior mediastinal mass

“…Anaesthesia for surgery of an anterior mediastinal mass is a challenge for cardiorespiratory and airway management in the perioperative period. Reports ( 1–15) of anterior mediastinal masses in paediatrics address these problems mostly in older children. In one review ( 9), the age of the patients varied from 1 day to 18 years, but children with serious airway problems requiring general anaesthesia were aged more than 5 years.…”