Olix Daniel J, Carollo Dominic S, Ural Kelly G
Department of Anesthesiology and Perioperative Medicine, Ochsner Clinic Foundation, New Orleans, LA.
The University of Queensland Medical School, Ochsner Clinical School, New Orleans, LA.
Ochsner J. 2023 Winter;23(4):363-366. doi: 10.31486/toj.23.0055.
Anterior mediastinal masses (AMMs), which can be benign or malignant, are a common cause of superior vena cava (SVC) syndrome. Because of their location, AMMs can cause significant airway compromise during the perioperative period, so anesthetic management of a patient with SVC syndrome can present significant challenges. A patient presented with SVC syndrome secondary to a large AMM. After careful consideration and discussion with the patient about the risks and benefits of various approaches, the decision was made to provide sedation using dexmedetomidine as the sole agent during image-guided biopsy. Patients who present with AMMs require careful anesthetic planning. Dexmedetomidine can be effective in achieving the primary objective of maintaining spontaneous respiration.
前纵隔肿物（AMM）可呈良性或恶性，是上腔静脉（SVC）综合征的常见病因。由于其位置特殊，AMM在围手术期可导致严重气道受压，因此SVC综合征患者的麻醉管理面临重大挑战。一名患者因巨大AMM继发SVC综合征。在与患者仔细考虑并讨论了各种方法的风险和益处后，决定在影像引导活检期间使用右美托咪定作为唯一药物进行镇静。患有AMM的患者需要仔细的麻醉规划。右美托咪定可有效实现维持自主呼吸的主要目标。
