Anesthesia for Mediastinoscopy and Mediastinal Surgery
Mediastinoscopy is widely utilized for the diagnosis and staging of diseases of the mediastinum. Most procedures are performed via a cervical incision. Patients may have significant co-morbidities related to their mediastinal disease such as large anterior mediastinal masses or Lambert-Eaton Syndrome. Anesthetic challenges include potential difficult ventilation and intubation, compression of the innominate artery and major hemorrhage. Knowledge of the implications of co-morbidities, mediastinal anatomy, surgical technique and associated complications are vital in the safe anesthetic care of patients for these procedures. Table 12.1 summarizes the anesthesia considerations for mediastinoscopy and mediastinal surgery.
KeywordsMediastinoscopy Chamberlain procedure Lambert-Eaton syndrome Anterior mediastinal mass Innominate artery compression
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