TYK346

A 15 year-old teenager comes to the operating room for mediastinoscopy and tissue biopsy of a newly diagnosed anterior mediastinal mass. A CT of the chest shows significant impingement of the mass on the trachea, and the patient has plethora of the face. The oncologist has requested the tissue biopsy to guide initial therapy. Which of the following is a mainstay of anesthetic management?

a) Assessment of severity of symptoms

b) Maintenance of spontaneous ventilation on induction

c) Contingency plan in the event of total airway obstruction

d) Both a and c

e) All of the above

Click for Answer

Answer

Answer e. Any anesthetic in a patient with an untreated mediastinal mass should be considered high-risk. A careful preoperative assessment must be undertaken, and an anesthetic plan must be constructed with care and a high degree of suspicion for total airway and/or vascular compromise upon loss of airway tone. Therefore, all answers listed are appropriate. Please see Book 8, Chapter 5 in this series for additional information about mediastinal masses in children.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

Keywords

---

---

<Prev Question --- Next Question>

About Test Your Knowledge