Anesthetic Management in Patient with Anterior Mediastinal Mass and Impending Cardiac Tamponade

Anesthetic Management in Patient with Anterior Mediastinal Mass

Abstract

Anterior mediastinal mass is a condition in which the airways and the cardiovascular system are compressed, leading to hypoxia and circulatory failure. This can be life-threatening when undergoing anesthesia for surgery. Emergency conditions make them more morbidity and mortality. A 68 years old female with anterior mediastinal mass with underlying non-small cell carcinoma and left pleural effusion, presented with clinical impending cardiac tamponade underwent general anesthesia for anterior thoracotomy with pericardial window. Anesthetic management was challenge, however it was smooth with a bendable endotracheal tube with fiberoptic intubation and light sedation on semi upright position. During step to supine position and titration of anesthetic agents, hemodynamic became worsening. After given resuscitation and changed position to right lateral position, cardiovascular and respiration improved and became more stable. Operation finished with safely uneventful. The patient remained intubated with endotracheal tube for postoperative ventilation supported and could extubated on the 3rd day after surgery. Studying patient information, treatment planning, choosing the proper intubation technique and administering anesthesia allows the patient to undergo surgery safely, no dangerous conditions and no complications