Patient repositioning and the amelioration of airway obstruction by an anterior mediastinal tumor during general anesthesia -A case report-.
An 18-year-old male with huge anterior mediastinum mass was scheduled for thoracotomic incisional biopsy under general anesthesia after failed fluoroscopy-guided percutaneous needle biopsy. Under propofol and succinylcholine anesthesia, intubation was successfully achieved using a Univent tube. However, when we changed the patient's position from supine to right lateral decubitus, oxygen saturation declined. He was then positioned supine, but hypoxemia did not improve. Because the tumor expanded toward the left thoracic field, we considered that the left lateral decubitus position might help relieve the mass effect on the main bronchus. His position was changed accordingly and soon after, hypoxemia improved and surgery was undertaken under cardiopulmonary bypass (CPB). The biopsy was successfully performed under CPB without complication.
Choi
Won Joon
WJ
Department of Anesthesiology and Pain Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Kim
Yun Hong
YH
Mok
Jeong Min
JM
Choi
Soo Il
SI
Kim
Hyun Soo
HS