Media stinoseo by in A Syn old

ton Ant mediastinum mass

e e dune
th on a air Sx b mo
cervical
Types
Ant en ion
Gham been lain
procedure
Indications Node
C Evaluation of lymph
involvement in eating
Tissue biopsy for suspected
tumours masses
Removal of mediastinal
Cii
and enlarged lymphnodes
staging of lung canteens
and treatment
c Diagnosis
of mesothelioma
mediastinal excision
i
Benign cyst
 contraindications
Inoperable tumours
previous mediastino Seo
by
bnerious recurrent laryngeal
nerve injury
d
Ascending Aortic aneurysm
C TO 0 sve syndrome
E tracheal deviation Geren e
Anaestheticeonsidenations
Patient undergoing mediastinoseo by
mass
for Ant mediastinal
A Patient factors
related Factors
B Procedure
related futons
e pathology 1 Mess
Related Factors
A Patient
H lo allergy
H lo e om on bidities if
bnesent ltrecently
oURTI LRTI Fevers
 Related factors
B Procedure
due to surgical compression
of major vessels
Antony compression
Innominate
b Pneumo mediastinum can
cause Reduction in ventilation
chance of airs
284k sad up Related embolism
Mass Pathology
C compression of adjacent
due to mass effect
structures
tracheo bronchial compression
can lead to bensistant RTI
wheeze stnidon
can worsen 49A
obstruction
chest wall tone
due to decreased
and eephalie displacement of
diaphragm
 lung eat Paraneoplastic syndrome

t
oSre GR longer action
syndrome anaesthetics
of
consider RTlet before procedure to
Goals I size of
Intraoperative mass
i Panalysis is negrined to be
maintained until end of
bnoeedure
will increase
coughing bucking
to nearby structures
risk of damage
i maintain non movolaemia
Iii Monitors for inominateAntony
compression
Pain control with opioids
Investigations
C Routine Haematology
i Urea eneatinine
iii Eea
ECHO Rko cardiac compression
Livy Relation
PTS an Goeation of mass to winword
C
i PET No Preexisting lung disease
assess mass effect
Both inspiratory and expiratory flow
are usually reduced
If only expinatonyflow I
dispropo
think tionately
of tracheomolecia

Anaesthetic Management
Pne Adequatefasting
Pnemedication should be
avoided if tracheal
obstruction is suspected
Monitoring Son
Rt hand Ceheek
C Pulse oxymetry compression
i nominate antony
Ee 9
Ant BP for early
Iii Invasive
reflex arrhythmias
detection of
Vessels
and compression to majors
 Tembenatane
c MM monitoring in Pt with my
L E syndrome
i ventilator pnessene gauge for
A in airway pressure

Induction secured
bone IV access
large attached
Monitors
Respiratory
asymptomatic obstruction
t tr
Pneoxygenate local anaesthetics
and Iv induction and awake
intubation
For More distal obstruction I
keep Rigid
bronchoscope
as bae Kulp
Reinforced tube is bnefenned
to minimize the risk of tube
kinking
 Sen Oz
inte mittent
o
Maintenance
of to pulp
Iv anaesthetic and
opioids and N M
blockers if needed

Extubation mass
longstanding
t
fibneoptie endoscopy
priors extuloation to
rule out tracheomdoeia
extubated only after full recovery
otnettexes and NM function
complications Major Haemorrhage
C Ain embolism
Surgical Pneumothorax

explonatiY
yphnenieNenv bahsy L
Post op R
Run palsy
to rule out