Background: Sedation of children undergoing biopsies of anterior mediastinal masses can be challenging because of the absolute necessity of ensuring minimal smooth muscle relaxation and preventing airway collapse. Furthermore, positive pressure ventilation may be difficult or impossible and may also pose the additional risks of hemodynamic compromise in the pediatric patient.
Case reports: We present a case series of 3 children who were successfully sedated for computed tomography (CT)-guided mediastinal biopsies with dexmedetomidine.
Conclusion: Dexmedetomidine, a selective alpha-2 adrenoreceptor agonist that maintains the smooth musculature of the pediatric airway, provides the ability to sustain spontaneous ventilation in patients with airway compression. Dexmedetomidine is a safe, reliable anesthetic for biopsy of children with anterior mediastinal masses.
Keywords: Adrenergic alpha-2 receptor agonists; dexmedetomidine; mediastinal neoplasms.