Anaesthetic management of an infant with anterior mediastinal mass

Abstract

A substantial mediastinal mass in a small infant can create a dilemma regarding the safest mode of airway management. To ensure safety at all times, we adopted one lung ventilation for fear of compression of the carina and/or both main bronchi. Anaesthesia was maintained at a very light plane by the use of local nerve blocks to secure the airway and epidural analgesia for surgery until the tumour was mobilized.

Vasoactive mediastinal mass in an infant

“…Intraoperative management of patients with anterior mediastinal masses has been well described in the literature [1][2][3][4][5]. On induction of anesthesia, both cardiovascular and respiratory collapse can occur.…”

Guía de Procedimiento en Pediatría: Intubación traqueal de emergencia en pediatría (Acceso Avanzado de Vía Aérea)

“…El paciente con una verdadera vía aérea difícil debe ser manejado por un intensivista o anestesiólogo pediátricos con experiencia. Los pacientes con grandes tumores de cabeza y cuello, así como síndrome de masa en mediastino constituyen situaciones de vía aérea de alto riesgo que ameritan manejarse en centros pediátricos especializados 5,6 .…”

Anesthetic considerations for the pediatric oncology patient – part 2: systems‐based approach to anesthesia

“…A fiberoptic and rigid bronchoscope should be immediately available (3,11). Induction of the child, for whom awake fiberoptic intubation is not often an option, should be carried out gradually with intravenous or inhalational agents, ensuring maintenance of spontaneous ventilation through the time of intubation (3,11,13). Continuation of spontaneous ventilation and avoidance of paralysis throughout the procedure is prudent.…”