Slinger Peter, Karsli Cengiz
Curr Opin Anaesthesiol. 2007 Feb;20(1):1-3. doi: 10.1097/ACO.0b013e328011390b.
This editorial review summarizes the current anesthetic management of patients with anterior mediastinal masses.
With increased appreciation of the correct intraoperative management of these cases severe intraoperative respiratory or cardiovascular collapse is less likely to occur during general anesthesia. Maintenance of spontaneous ventilation is the anesthetic goal whenever possible. Major life-threatening complications now occur more frequently postoperatively.
General anesthesia is not safe in patients with severe positional symptoms from an anterior mediastinal mass. With modern imaging techniques, general anesthesia is rarely needed for diagnostic procedures in these patients. Preoperative flow-volume loops are not useful in the management of these patients and the concept of cardiopulmonary bypass on 'standby' is not appropriate during induction of anesthesia.
本编辑综述总结了当前前纵隔肿物患者的麻醉管理。
随着对这些病例正确术中管理的认识增加，全身麻醉期间严重的术中呼吸或心血管虚脱不太可能发生。尽可能维持自主通气是麻醉目标。现在主要的危及生命的并发症更多发生在术后。
对于有前纵隔肿物严重体位症状的患者，全身麻醉不安全。借助现代成像技术，这些患者的诊断程序很少需要全身麻醉。术前流量-容积环对这些患者的管理无用，且在麻醉诱导期间“备用”体外循环的概念不合适。
