Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.012
Brazilian Journal of Anesthesiology
Case Report

Perioperative anesthesia management of a pregnant patient with central airway obstruction: a case report

Cuidado perioperatório anestésico de gestante com obstrução central de via aérea: relato de caso

Keevan Singh, Shenelle Balliram, Rachael Ramkissun

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Abstract

Mediastinal masses in pregnancy, although rare, can present with life threatening central airway obstruction if general anesthesia is required. In patients with central airway obstruction who are classified as being high risk for anesthesia, specific cardiothoracic interventions are usually required when there is no alternative to general anesthesia. We describe the case of a young female who presented in her second trimester with severe tracheal compression and worsening dyspnea secondary to a mediastinal mass. Intravenous dexamethasone was started, following which her symptoms improved and a drastic reduction in her tracheal compression was observed. The patient subsequently underwent successful vaginal delivery under epidural anesthesia. We discuss the complexities in perioperative decision making for this rare presentation and potential therapeutic options.

Keywords

Tracheal compression;  Pregnancy;  Mediastinal mass

References

1 P. Béchard, L. Létourneau, Y. Lacasse, D. Côté, J.S. Bussières Perioperative cardiorespiratory complications in adults with mediastinal mass: incidence and risk factors Anesthesiology., 100 (2004), pp. 826-834 discussion 5A

2 RS Blank, DG. de Souza Anesthetic management of patients with an anterior mediastinal mass: continuing professional development Can J Anaesth., 58 (2011) 853-9, 860-7

3 NAP4: Major Complications of Airway Management in the United Kingdom – The National Institute of Academic Anaesthesia [Internet]. [cited 2020 Oct 12]. Available from: https://www.nationalauditprojects.org.uk/NAP4_home.

4 JWW. Gothard Anesthetic Considerations for Patients with Anterior Mediastinal Masses Anesthesiol Clin., 26 (2008), pp. 305-314

5 Y. Kobayashi, Y. Fujii, M. Yano, et al. Preoperative steroid pulse therapy for invasive thymoma: clinical experience and mechanism of action Cancer., 106 (2006), pp. 1901-1907

6 G. Erdös, I. Tzanova Perioperative anaesthetic management of mediastinal mass in adults Eur J Anaesthesiol EJA., 26 (2009), pp. 627-632
 

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