[Anesthetic Management of the Patient with an Anterior Mediastinal Tumor].

Motohiko Hanazaki
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Abstract

Perioperative management of the patient with anterior mediastinal tumor is challenging and should not be underestimated. The clinical presentation of the patient is variable because it depends on the size and localiza- tion of the tumor. Therefore, it is difficult to establish a structured protocol for anesthetic management of ante- rior mediastinal tumor. Anesthesiologists are required to make careful anesthetic plan with thorough assessment of preoperative status of the patient Confirmation of "comfortable position" for the patient is important and useful for safe management The induction of general anesthesia should be performed in step-by-step wise without muscle relaxants. Even after successful tracheal intubation, difficult ventilation may occur. Preparation of percutaneous cardiopulmonary support (PCPS) is essential for the emergency situation from both respiratory and circulatory collapses, especially during anesthesia induction. For emergency use of PCPS, cannulation of femoral vessels under local anesthesia should be performed before anesthesia induction in the patient with subjective respiratory symptom and severe tracheal compression.

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前纵隔肿瘤患者的麻醉处理。
前纵隔肿瘤患者的围手术期管理是具有挑战性的,不应低估。患者的临床表现是可变的,因为它取决于肿瘤的大小和位置。因此,很难建立一套结构化的前纵隔肿瘤麻醉处理方案。麻醉医师需要制定周密的麻醉计划,充分评估患者的术前状态,确认患者的“舒适体位”对安全管理非常重要和有用。全身麻醉的诱导应逐步进行,不使用肌肉松弛剂。即使气管插管成功,也可能出现通气困难。准备经皮心肺支持(pps)是必不可少的紧急情况下,从呼吸和循环衰竭,特别是在麻醉诱导。对于有主观呼吸症状且气管压迫严重的患者,应在麻醉诱导前行局麻下股血管插管。
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