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Curr Opin Anaesthesiol · Feb 2007
EditorialManagement of the patient with a large anterior mediastinal mass: recurring myths.
- Peter Slinger and Cengiz Karsli.
- Curr Opin Anaesthesiol. 2007 Feb 1;20(1):1-3.
Purpose Of ReviewThis editorial review summarizes the current anesthetic management of patients with anterior mediastinal masses.Recent FindingsWith 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.SummaryGeneral 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.
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