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Canadian Journal of Anesthesia, Vol 40, 46-49, Copyright © 1993 by Canadian Anesthesiologists' Society

ARTICLES

Anterior mediastinal mass in a patient susceptible to malignant hyperthermia

GC Allen, LJ Byford and FM Shamji
Department of Anaesthesia, Ottawa Civic Hospital, Ontario.

We report a malignant hyperthermia-susceptible patient who required investigation for a large, symptomatic anterior mediastinal mass. Multiple attempts at tissue diagnosis under local anaesthesia were unsuccessful. Following awake fibreoptic tracheal intubation, general anaesthesia was administered using ketamine, midazolam, and nitrous oxide, maintaining spontaneous ventilation. Prophylactic dantrolene was not used, to avoid potential muscle weakness and respiratory compromise. Diagnostic mediastinotomy was performed without incident. We conclude that ketamine anaesthesia is appropriate for patients with anterior mediastinal masses, and is considered safe in malignant hyperthermia-susceptible patients.




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Copyright © 1993 by the Canadian Anesthesiologists' Society.