Furuya A, Matsukawa T, Kumazama T
Department of Anesthesia, Yamanashi Medical University.
Masui. 1996 Jan;45(1):107-10.
We report a case of thymoma presenting superior vena cava syndrome. Anesthesia for biopsy or excision of an anterior mediastinal mass has been associated with major airway and cardiac complications. Therefore, careful anesthetic management is necessary. The patient was kept on Fowler's position, and anesthesia was induced with thiamylal. The patient was intubated with succinylcholine and allowed to breath spontaneously until the sternal incision. Thereafter we used vecuronium and controlled ventilation was maintained. Intraoperatively, arterial pressure, central venous pressure, and right- and left-brachiocephalic vein pressures were monitored. After bypasses between right atrium and right- and left-brachiocephalic vein had been made, the venous pressures decreased remarkably. Various methods for preventing side effects resulted in good control during the perioperative period.
我们报告一例表现为上腔静脉综合征的胸腺瘤病例。前纵隔肿物活检或切除的麻醉一直与严重气道和心脏并发症相关。因此，谨慎的麻醉管理是必要的。患者保持福勒氏位，用硫喷妥钠诱导麻醉。患者用琥珀酰胆碱插管，并在胸骨切开前允许自主呼吸。此后我们使用维库溴铵并维持控制通气。术中监测动脉压、中心静脉压以及左右头臂静脉压。在右心房与左右头臂静脉之间建立旁路后，静脉压显著下降。围手术期采用各种预防副作用的方法，效果良好。
