Review Note
Last Update: 02/20/2025 02:16 AM
Current Deck: ACG Part 2::Thoracic SSU
New Card (Unpublished)Currently Published Content
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Pending Suggestions
Field Change Suggestions:
Front
Commit #286270
SS_TS 1.13 Discuss the anaesthetic management of the following procedures:
Mediastinoscopy
Mediastinoscopy
Back
Commit #286270Procedure: Inspection and biopsy of tumours and lymph nodes in superior and anterior mediastinum via small suprasternal or anterior intercostal incision
Time: 20–30min
Pain +
Position: Supine or slightly head up, arms by sides, and head ring with bolster under shoulders
Blood loss: Usually minimal, but potential for massive haemorrhage; G&S
Practical techniques: IPPV via SLT
LA and/or propofol TCI for endobronchial ultrasound
Pre-op:
- Day case procedure for appropriate patients
- Usual history and examination, investigations: CT chest, CXR
- Check for SVC obstruction or tracheobronchial compression
- Consider mediastinal mass compression (see mediastinal mass section)
Intra-op:
- Single lumen tube
- IVL in leg following induction usually 16ga
- Monitor tidal volume and airway pressure - may have surgical compression of airway
- Usually supine or slightly head up, head/airway covered by drapes
Post-op:
- Pain relief: simple analgesia
- Extubation in theatre
