Keywords : Airway compression
ANESTHETIC MANAGEMENT OF ANTERIOR MEDIASTINAL MASS IN 7 YEARS, OLD CHILD POSTED FOR DIAGNOSTIC BIOPSY
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 7459-7463
Background: Anterior mediastinal mass can lead to life threatening airway compression and impingement on heart and great vessels. Mortality is high, especially in children, due to pliable rib cage and difficulties in symptomatic assessment preoperatively. Respiratory symptoms include dyspnea, orthopnea, cyanosis, cough, wheeze, and stridor. Cardiovascular symptoms include syncope, headache, and facial swelling that worsens with Valsalva, and on physical examination jugular venous distention, facial/neck oedema, blood pressure changes with postural changes, and increased pulsus paradoxus.
Case report: We reported a case of symptomatic 7years old male child with a radiographic finding of a mediastinal mass posted for diagnostic biopsy and discuss the anesthetic management for the same.
Conclusion: It appears prudent to avoid general anesthesia, when possible, for patients at the highest risk. When general anesthesia is required, a comprehensive plan must be formulated preoperatively with the surgical team.