Anaesthetic Concerns of an Anterior Mediastinal Mass

Managing a child with anterior mediastinal mass is considered as one of the most challenging cases ever encountered by an anesthetist. The main concerns are not only related to managing the airway and maintaining ventilation with the most suitable mode, but also the associated cardiovascular complications, where the patient is at risk of cardiorespiratory embarrassment before, during and after induction of anaesthesia. Furthermore, managing children during anaesthesia produces an array of implications, hence thorough preoperative assessment is essential to ensure that the children are safely induced with the general anesthetic drugs, the airway is securely protected and the anxious parents are given ample explanations and are comforted. A case report of an unfortunate boy who required an elective intubation prior to investigations to establish his diagnosis is presented. The aim emphasizes on highlighting our main concerns and strategies pre, during & post induction of anaesthesia from an anaesthetist's point of view.