Anesthetic management of children with an anterior mediastinal mass

J Clin Anesth. 2010 May;22(3):159-63. doi: 10.1016/j.jclinane.2009.10.004.

Abstract

Study objective: To review the anesthetic management and perioperative course of children with an anterior mediastinal mass.

Design: Retrospective review.

Setting: University-affiliated children's hospital.

Measurements: The records of 46 children presenting with an anterior mediastinal mass between October 1, 1998 and October 1, 2006 were studied. Preoperative symptoms, diagnostic imaging and physical examination findings, anesthetic techniques, and perioperative complications were recorded.

Main results: Spontaneous ventilation was maintained in 21 of 46 cases. Five patients had mild intraoperative complications, including upper airway obstruction, mild oxyhemoglobin desaturation, wheezing, partial airway obstruction, and a pneumothorax after mediastinal mass biopsy. There were no serious complications or perioperative deaths.

Conclusions: Children with a symptomatic anterior mediastinal mass underwent general anesthesia without serious complications. Spontaneous ventilation was preferred for all patients with severe airway compression.

MeSH terms

  • Adolescent
  • Airway Obstruction / etiology
  • Airway Obstruction / prevention & control*
  • Anesthesia, General / methods*
  • Anesthesia, General / trends
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Intraoperative Complications / etiology
  • Intraoperative Complications / prevention & control*
  • Male
  • Mediastinal Neoplasms / pathology
  • Mediastinal Neoplasms / surgery*
  • Oxygen / blood
  • Pneumothorax / etiology
  • Pneumothorax / prevention & control*
  • Respiratory Sounds / etiology
  • Retrospective Studies

Substances

  • Oxygen