General anesthesia for biopsy of an anterior mediastinal mass MAY be acceptable in which of the following circumstances:

a) Severe positional orthopnea

b) Tracheal cross-sectional area 70% predicted

c) Compression of the main pulmonary artery

d) Large pericardial effusion with systolic right-atrial collapse

e) Stridor

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Answer

Answer b. With the exception of B, all of the above answers are suggestive of severe cardiopulmonary obstruction for which general anesthesia would be considered contraindicated. Tracheal compression resulting in a cross sectional area <50% predicted is the most commonly cited contraindication.

Notes

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

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