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anesthesia mediastinal mass

Adam C Adler, Emily R Schwartz, Jennifer M Waters, Paul A Stricker
Anesthetic management of the child with an anterior mediastinal mass is challenging. The surgical/procedural goal typically is to obtain a definitive tissue diagnosis to guide treatment; the safest approach to anesthesia is often one that alters cardiorespiratory physiology the least. In severe cases, this may translate to little or no systemic sedatives/analgesics. Distraction techniques, designed to shift attention away from procedure-related pain (such as counting, listening to music, non-procedure-related talk), may be of great benefit, allowing for avoidance of pharmaceuticals...
December 2016: Journal of Clinical Anesthesia
Nina Sulen, Barbara Petani, Ivan Bacić, Domagoj Morović
Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near fatal cardiorespiratory complications have been reported. We describe anesthetic management of a patient with posterior mediastinal mass compressing the trachea and the left main bronchus presented for left thoracotomy and tumor excision...
March 2016: Acta Clinica Croatica
Suman Rajagopalan, Mark Harbott, Jaime Ortiz, Venkata Bandi
The anesthetic management of patients with large mediastinal masses can be complicated due to the pressure effects of the mass on the airway or major vessels. We present the successful anesthetic management of a 64-year-old female with a large mediastinal mass that encroached on the great vessels and compressed the trachea. A tracheal stent was placed to relieve the tracheal compression under general anesthesia. Spontaneous ventilation was maintained during the perioperative period with the use of a classic laryngeal mask airway...
March 2016: Brazilian Journal of Anesthesiology
Karan Madan, Pramod Garg, Sushil K Kabra, Anant Mohan, Randeep Guleria
Evaluation of mediastinal lymphadenopathy in children is challenging and surgical procedures (mediastinoscopy/thoracotomy) are usually performed wherever tissue sampling is required. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a widely utilized and minimally invasive modality for evaluation of mediastinum (lymphadenopathy, masses, and nodal staging in patients with lung cancer) in adults. Smaller size of pediatric trachea potentially limits the use of EBUS. The EBUS bronchoscope can also be introduced into the esophagus for mediastinal evaluation and sampling, a technique described as transesophageal bronchoscopic ultrasound-guided fine-needle aspiration (EUS-B-FNA)...
October 2015: Journal of Bronchology & Interventional Pulmonology
Mumin Hakim, Candice Burrier, Tarun Bhalla, Vidya T Raman, David P Martin, Olamide Dairo, Joel L Mayerson, Joseph D Tobias
Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement...
2015: Journal of Pain Research
Jared Kevin Pearson, Gee Mei Tan
One of the more challenging cases facing a pediatric anesthesiologist is the management of patients presenting with an anterior mediastinal mass (AMM). Patients with an AMM may have severe cardiopulmonary compromise that can be exacerbated when undergoing general anesthesia. Several case reports have documented cardiopulmonary collapse during induction or maintenance of general anesthesia and even for procedures done without anesthesia. Despite increased understanding and management of these patients, perioperative complications, defined as anything from transient decreases in blood pressure correcting with fluids or mild airway obstruction requiring no intervention, to complete cardiopulmonary collapse, are still estimated to occur during 9% to 20% of anesthetic procedures...
September 2015: Seminars in Cardiothoracic and Vascular Anesthesia
Shannon N Acker, Jacqueline Linton, Gee Mei Tan, Timothy P Garrington, Jennifer Bruny, Joanne M Hilden, Lindsey M Hoffman, David A Partrick
PURPOSE: Anterior mediastinal masses (AMM) pose a diagnostic challenge to surgeons, oncologists, anesthesiologists, intensivists, and interventional radiologists as induction of general anesthesia can cause airway obstruction and cardiovascular collapse. We hypothesized that in the majority of patients, diagnosis can be obtained through biopsy of extrathoracic tissue. METHODS: We performed a retrospective review of all patients in the solid tumor oncology clinic with a diagnosis of AMM between 2002 and 2012 including preoperative evaluation and management prior to obtaining a tissue diagnosis, clinical course and complications...
May 2015: Journal of Pediatric Surgery
S D Popov, N A Il'ina
Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential, a marked inflammatory component, and characteristic genetic changes. Once it was identified as an independent nosological entity from a rather heterogeneous group of inflammatory pseudotumors. This paper describes a case of inflammatory myofibroblastic tumor of the chest in a child, by discussing the criteria for differential diagnosis in the use of up-to-date radiology techniques. When thoracic neoplasms are detected, it is necessary to determine their site and the most likely origin organ as exactly as possible and to assess the X-ray pattern of the pathological process...
November 2013: Vestnik Rentgenologii i Radiologii
Yatish Bevinaguddaiah, Shivakumar Shivanna, Vinayak Seenappa Pujari, Manjunath Abloodu Chikkapillappa
Anterior mediastinal mass is a rare pathology that presents considerable anesthetic challenges due to cardiopulmonary compromise. We present a case that was referred to us in the third trimester of pregnancy with severe breathlessness and orthopnea. An elective cesarean delivery was performed under combined spinal epidural anesthesia with a favorable outcome. We discuss the perioperative considerations in these patients with a review of the literature.
October 2014: Saudi Journal of Anaesthesia
Sameh M Said, Brian J Telesz, George Makdisi, Fernando J Quevedo, Rakesh M Suri, Mark S Allen, William J Mauermann
Management of a large mediastinal mass causing respiratory and hemodynamic compromise represents a major challenge during induction of anesthesia and surgical resection. The hemodynamic changes associated with anesthetic induction and initiation of positive-pressure ventilation can lead to acute hemodynamic collapse or inability to ventilate, or both. Initiation of cardiopulmonary bypass before anesthetic induction represents a safe alternative. We present a 37-year-old woman who underwent successful resection of a large anterior mediastinal mass through sternotomy...
October 2014: Annals of Thoracic Surgery
Jeounghyuk Lee, Yong Chul Rim, Junyong In
Perioperative management of patients with an anterior mediastinal mass is difficult. We present a 35-year-old woman who showed delayed compression of the carina and left main bronchus despite no preoperative respiratory signs, symptoms, or radiologic findings due to an anterior mediastinal mass and uneventful stepwise induction of general anesthesia. Even use of a fiberoptic bronchoscope (FB) after induction of anesthesia was not helpful to predict delayed compression of the airway. Therefore, the anesthesiologist and the cardiothoracic surgeon must prepare for unexpected delayed compression of the airway, even in low risk patients who are asymptomatic or mildly symptomatic without postural symptoms or radiographic evidence of significant compression of structures...
June 2014: Journal of Thoracic Disease
Abdul Hamid Alraiyes, Khalid Alokla, Fayez Kheir, Jaime Palomino
BACKGROUND: A right-sided aortic arch (RAA) is a rare anomaly of the cardiovascular system, presenting in only 0.1% of the population. In some reported cases, RAA is accompanied by another cyanotic vascular anomaly such as tetralogy of Fallot, and patients with such anomalies are usually diagnosed in fetal life or early childhood. Most patients are asymptomatic if the RAA presents individually. CASE REPORT: We report the case of a 27-year-old African American man who presented to urgent care with 3 weeks of progressive dry cough with mild shortness of breath, low-grade fevers, and night sweats...
2014: Ochsner Journal
Michael Fabbro, Prakash A Patel, Harish Ramakrishna, Elizabeth Valentine, Edward A Ochroch, John G Agoustides
No abstract text is available yet for this article.
June 2014: Journal of Cardiothoracic and Vascular Anesthesia
Prakash Kumar Dubey
A 3-month-old male child underwent uneventful inguinal herniotomy under general anesthesia. After extubation, airway obstruction followed by pulmonary edema appeared for which the baby was reintubated and ventilated. The baby made a complete recovery and extubated after about 2 h. A post-operative computed tomography scan revealed a posterior mediastinal cystic mass abutting the tracheal bifurcation. Presumably, extrinsic compression by the mass on the tracheal bifurcation led to the development of negative pressure pulmonary edema...
April 2014: Annals of Cardiac Anaesthesia
Suvadeep Sen, Anjolie Chhabra, Arpita Ganguly, Dalim Kumar Baidya
Anesthesia in the presence of a mediastinal mass is difficult and challenging as the mass can involve or compress the heart, great vessels, tracheo-bronchial tree and the surrounding structures. We describe a case of severe tracheo-bronchial obstruction requiring emergency tracheostomy during the intraoperative period after an uneventful induction of anesthesia in a patient with a large esophageal polyp presenting as a posterior mediastinal mass.
January 2014: Journal of Anaesthesiology, Clinical Pharmacology
Sung Kyu Rim, Yu Bin Son, Jong Il Kim, Ji Heui Lee
No abstract text is available yet for this article.
December 2013: Korean Journal of Anesthesiology
Mario Santini, Alfonso Fiorelli, Giovanni Vicidomini, Gaetana Messina, Marina Accardo
OBJECTIVE: To valuate if the LigaSure (Valleylab, Boulder, Colorado, United States) vessel-sealing system could reduce operative time, intraoperative blood loss, drainage duration, and hospital stay in patients with anterior mediastinal mass undergoing open resection. METHODS: Forty consecutive patients having resection of anterior mediastinal mass were randomized into two groups according to whether LigaSure was used (n = 20) or not (n = 20). Tumor size, operative time, intraoperative blood loss, chest tube output and duration, length of hospital stay, morbidity, and mortality were prospectively recorded, then intergroup differences were statistically analyzed...
April 2015: Thoracic and Cardiovascular Surgeon
Chrystelle Sola, Olivier Choquet, Olivier Prodhomme, Xavier Capdevila, Christophe Dadure
Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures...
May 2014: Paediatric Anaesthesia
Parin Lalwani, Rajiv Chawla, Mritunjay Kumar, Akhilesh S Tomar, Padmalatha Raman
Anesthetic management of mediastinal masses is challenging. There is abundant literature available on anesthesia management of anterior mediastinal mass. Anesthetic management of posterior mediastinal mass lesions normally have uneventful course. We describe airway collapse and difficult mechanical ventilation in the postoperative period in a patient with posterior mediastinal mass.
October 2013: Annals of Cardiac Anaesthesia
Christopher R Gilbert, Alexander Chen, Jason A Akulian, Hans J Lee, Momen Wahidi, A Christine Argento, Nichole T Tanner, Nicholas J Pastis, Kassem Harris, Daniel Sterman, Jennifer W Toth, Praveen R Chenna, David Feller-Kopman, Lonny Yarmus
INTRODUCTION: The presence of intrathoracic lymphadenopathy and mediastinal masses in the pediatric population often presents a diagnostic challenge. With limited minimally invasive methodologies to obtain a diagnosis, invasive sampling via mediastinoscopy or thoracotomy is often pursued. Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, outpatient procedure that has demonstrated significant success in the adult population in the evaluation of such abnormalities...
August 2014: Pediatric Pulmonology
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