Anesthetic considerations for patients with anterior mediastinal masses

Anesthesiol Clin. 2008 Jun;26(2):305-14, vi. doi: 10.1016/j.anclin.2008.01.002.

Abstract

Anterior mediastinal tumors can cause severe airway and vascular compression, and these effects are exacerbated by general anesthesia. Tumor biopsy using a local anesthetic technique is preferable. General anesthesia for a biopsy procedure or resection of an anterior mediastinal mass should be undertaken only after a thorough preoperative assessment. Treatment protocols for surgery and anesthesia vary from institution to institution, and management remains operator dependent. Some consider the maintenance of spontaneous respiration during anesthesia optimal. Others advocate airway stenting. Cardiopulmonary bypass, instituted at the outset of surgery under local anesthetic, may be used as a fall-back technique in extreme circumstances.

Publication types

  • Review

MeSH terms

  • Anesthesia*
  • Biopsy
  • Cardiopulmonary Bypass
  • Diagnostic Imaging
  • Humans
  • Mediastinal Neoplasms / diagnosis
  • Mediastinal Neoplasms / pathology
  • Mediastinal Neoplasms / surgery*
  • Respiratory Mechanics
  • Risk Factors
  • Stents