Dexmedetomidine Used to Maintain Spontaneous Ventilation in a Patient With Anterior Mediastinal Mass and Superior Vena Cava Syndrome.

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.