Anterior mediastinal mass in a patient susceptible to malignant hyperthermia：（前纵隔质量在病人容易恶性高热）.pdfVIP

46 Clinical Reports Anterior mediastinal mass in a patient susceptible to malignant Gregory C. Allen MD FRCPC,Larry J. Byford MO FROC, hyperthermia Farid M. Shamji MO FRCSC We report a malignant hyperthermia-susceptible patient who anesth~sique ne pr~sente pas de dangers particuliers pour les required investigation for a large, symptomatic anterior me- patients dont la susceptibilit~ ~ lhyperthermie maligne est diastinal mass. Multiple attempts at tissue diagnosis under local connue. anaesthesia were unsuccessful. Following awakefibreoptic tra- cheal intubation, general anaesthesia was administered using ketamine, midazolam, and nitrous oxide, maintaining spon- The anaesthetic management of a patient with a large taneous ventilation. Prophylactic dantrolene was not used, to anterior mediastinal mass is challenging. Severe cardio- avoid potential muscle weakness and respiratory compromise. pulmonary complications may occur at any time, related Diagnostic mediastinotomy was performed without incident. to compression of vital mediastinal structures. We re- We conclude that ketamine anaesthesia is appropriate for pa- cently managed a patient with a large, symptomatic an- tients with anterior mediastinal masses, and is considered safe terior mediastinal mass, who was also susceptible to ma- in malignant hyperthermia-susceptible patients. fignant hyperthermia (MH). Nous rapportons lbbservation dun patient connu pour sa sus- Case report ceptibiliM h l~yperthermie maligne et qui doit subir une in- A 21-yr-old woman presented with