Anesthetic management of children with an anterior mediastinal mass.

STUDY OBJECTIVE To review the anesthetic management and perioperative course of children with an anterior mediastinal mass. DESIGN Retrospective review. SETTING University-affiliated children's hospital. MEASUREMENTS The records of 46 children presenting with an anterior mediastinal mass between October 1, 1998 and October 1, 2006 were studied. Preoperative symptoms, diagnostic imaging and physical examination findings, anesthetic techniques, and perioperative complications were recorded. MAIN RESULTS Spontaneous ventilation was maintained in 21 of 46 cases. Five patients had mild intraoperative complications, including upper airway obstruction, mild oxyhemoglobin desaturation, wheezing, partial airway obstruction, and a pneumothorax after mediastinal mass biopsy. There were no serious complications or perioperative deaths. CONCLUSIONS Children with a symptomatic anterior mediastinal mass underwent general anesthesia without serious complications. Spontaneous ventilation was preferred for all patients with severe airway compression.