Management of mediastinal syndromes in pediatrics: a new challenge of ultrasound guidance to avoid high-risk general anesthesia.
Adverse events associated with anesthetic management of anterior mediastinal masses in pediatrics are common. To avoid an extremely hazardous general anesthesia, the use of real-time ultrasonography offers an effective alternative in high-risk cases. We report the anesthetic management including a light sedation and ultrasound guidance for regional anesthesia, surgical node biopsy, and placement of a central venous line in two children with an anterior symptomatic mediastinal mass. For pediatric patients with clinical and/or radiologic signs of airway compression, ultrasound guidance provides safety technical assistance to avoid general anesthesia and should be performed for the initial diagnostic and therapeutic procedures.
Department of Anesthesia and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France.
Chrystelle
C
Sola
Olivier
O
Choquet
Olivier
O
Prodhomme
Xavier
X
Capdevila
Christophe
C
Dadure
D000293:Adolescent; D000577:Amides / Q000008:administration & dosage; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002405:Catheterization, Central Venous / Q000379:methods; D002572:Cervical Plexus / Q000000981:diagnostic imaging*; D066008:Cervical Plexus Block / Q000379:methods*; D002648:Child; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000601:surgery*; D012306:Risk; D000077212:Ropivacaine; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D013577:Syndrome; D018084:Ultrasonography, Interventional / Q000379:methods*
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine
mediastinal syndromes; pediatrics anesthesia; regional anesthesia; ultrasound guidance