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Case Report

Anesthetic Management of Patient with Mediastinal Tumor Posted for Thoracotomy and Tumor Excision

Lavanya Kaparthi null, Padmasree Mk 1 null, Lavanya Kaparthi 2 null, Ravi Madhusudhana 3 null, Preethi R 4 null

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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

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Indian Journal of Anesthesia and Analgesia 9(4):p 190-192, july-august 2022. | DOI: https://doi.org/10.21088/ijaa.2349.8471.9422.20

How Cite This Article:

Padmasree Mk, Lavanya Kaparthi, Ravi Madhusudhana, et al./Anesthetic Management of Patient with Mediastinal Tumor Posted for Thoracotomy and Tumor Excision/Indian J Anesth Analg. 2022;9(4):190-192

Timeline

Received : April 20, 2022         Accepted : May 26, 2022          Published : August 18, 2022

Abstract

Introduction: Mediastinal tumor are uncommon entity they present a major anesthetic challenges due to major  airway and vascular compression. Case Report: A 60yr, old diagnosed with posterior mediastinum tumour at C7 level. Airway assessment revealed  mallampatti class IV. Blood investigations were within normal limit. Pulmonary function test revealed mild  obstructive disease. CT shows lesion in posterior mediastinum extending to right IJV with complete thrombosis  displacing trachea and thyroid. Triple lumen CVP line was secured. Difficult intubation trolley with tracheostomy  set was kept ready. Routine monitoring, left radial artery cannulation done. Patient was Preoxygenated,  Premedicated and Induced. 37F Left Double lumen tube was inserted and tube position confirmed with paediatric  fiberoptic bronchoscope. Patient was hemodynamically stable in the intraoperative period. Patient was reversed  and extubated uneventfully. Conclusion: Mediastinal tumor resection surgery is a very complicated and requires a team effect anesthesiologists,  surgeon and intensivist. A thorough pre-operative assessment of the patient should be done before the conduct of  anesthesia to avoid the complications due to posterior mediastinal mass. Keywords: Thoracotomy, One-Lung Ventilation, Mediastinal Tumor. Key Messages: Anesthetic management of patient with mediastinal tumor posted for thoracotomy and tumor  excision requires a double lumen ET tube for lung isolation and decrease in lung atelectasis. In this case a 60  year old male presented with mild symptoms and we highlight the usage of one lung ventilation in patient with  posterior mediastinal tumor

References

  • 1.   Lalwani P, Chawla R, Kumar M, Tomar AS, Raman P. Posterior mediastinal mass: do we need to worry much? Ann Card Anaesth. 2013
  • 2.   Saiyed A, Meena R, Ambesh B, Verma I. Anesthetic management of posterior mediastinal mass: a case report. Egypt J Cardiothorac Anesth 2014;8:104-7
  • 3.   Tewari S, Goyal P, Rastogi A, Agarwal A, Singh PK.Ann Card Anaesth. 2017 Jul-Sep;20(3):359-361
  • 4.   David M. Anderson, Galina T. Dimitrova, Hamdy Awad; Patient with Posterior Mediastinal Mass Requiring Urgent Cardiopulmonary Bypass. Anesthesiology 2011; 114:1488–1493
  • 5.   John F. Zaki, Stephanie F. Tran, Travis Markham, Warren Choi, Rodolfo E. Perez, et al. (2017), Does the Patient Need Lung Protection or Lung Isolation? A Case Report and Literature Review of One-Lung Ventilation Guidelines. Int J Ane & Rel. 1:1, 13-15

Data Sharing Statement

There are no additional data available. All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.

Conflicts of Interest

No conflicts of interest in this work.

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Cite this article

Padmasree Mk, Lavanya Kaparthi, Ravi Madhusudhana, et al./Anesthetic Management of Patient with Mediastinal Tumor Posted for Thoracotomy and Tumor Excision/Indian J Anesth Analg. 2022;9(4):190-192

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.

Received Accepted Published
April 20, 2022 May 26, 2022 August 18, 2022
DOI: https://doi.org/10.21088/ijaa.2349.8471.9422.20

Keywords

ThoracotomyOne-Lung VentilationMediastinal Tumor.One-Lung VentilationMediastinal Tumor.

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Timeline

Received April 20, 2022
Accepted May 26, 2022
Published August 18, 2022

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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