title: Anesthetizing a child for a large compressive mediastinal mass with distraction techniques and music therapies as the sole agents.
abstract: Anesthetic management of the child with an anterior mediastinal mass is challenging. The surgical/procedural goal typically is to obtain a definitive tissue diagnosis to guide treatment; the safest approach to anesthesia is often one that alters cardiorespiratory physiology the least. In severe cases, this may translate to little or no systemic sedatives/analgesics. Distraction techniques, designed to shift attention away from procedure-related pain (such as counting, listening to music, non-procedure-related talk), may be of great benefit, allowing for avoidance of pharmaceuticals. In this report, we present an approach in children where the anesthetic risk is deemed excessive.
authors.affiliation: Assistant Professor of Cardiovascular Anesthesiology, Texas Children's Hospital, Houston, TX; Department of Anesthesiology, Perioperative and Pain Medicine, Baylor College of Medicine, Houston, TX. Electronic address: axadler@texaschildrens.org.
authors.forename: Adam C
authors.initials: AC
authors.lastname: Adler
authors.affiliation: Brown University, Providence, RI. Electronic address: emily_r_schwartz@brown.edu.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Schwartz
authors.affiliation: Pediatric Psychologist, Department of Anesthesiology, Children's Hospital of Minnesota, Minneapolis, MN. Electronic address: jennifer.waters@childrensmn.com.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Waters
authors.affiliation: Assistant Professor of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania. Electronic address: strickerp@email.chop.edu.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Stricker
mesh_terms: D000758:Anesthesia / Q000379:methods*; D001296:Audiovisual Aids; D002648:Child; D005260:Female; D006801:Humans; D008479:Mediastinal Neoplasms / Q000601:surgery*; D009146:Music
keywords: Anesthesia; Cardiac; Distraction; Mediastinal; Pediatric; Tamponade