Anestesia en tumor de mediastino anterior en pediatría: a propósito de un caso

Abstract

Introduction:

Anterior mediastinal masses in pediatric patients pose a significant anesthetic challenge due to the risk of respirator y  and c ardiovascular collapse during anesthetic induction, with a high risk of morbidity and mortality.

Case:

We report the anesthetic management of a 4-year-old, 20 kg child with an anterior mediastinal mass and superior vena cava syndrome scheduled for incisional biopsy.

Induction was performed with sevoflurane while maintaining spontaneous ventilation and continuous possitive airway pressure (CPAP), in the right lateral decubitus position. Rigid bronchoscopy was used to assess airway patency be- fore endotracheal intubation without muscle relaxants. During surgery, an accidental extubation occurred, which was promptly managed with reintubation without further complications. The patient required postoperative mechanical ventilation in the intensive care unit and was successfully extubated the following day.Final histopathology revealed a mature B-cell lymphoma.

Conclusion:

Multidisciplinary planning, preservation of spontaneous ventilation, and readiness for emergency interventions are essential to minimize anesthetic risk in children with anterior mediastinal masses.