Anesthetic Implications of SVC Syndrome
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Questions and Answers

Which type of tumors are most likely to produce SVC compression according to the text?

  • Mesothelioma
  • Oat-cell carcinoma (correct)
  • Adenocarcinoma
  • Squamous cell carcinoma
  • What symptoms may patients with SVC obstruction present with?

  • Fullness in the abdomen
  • Tongue swelling and upper airway edema (correct)
  • Dilated veins across the lower chest
  • Blue discoloration of the legs
  • How can symptoms of SVC obstruction be relieved?

  • By lying in a prone position
  • By bending the knees
  • By head elevation (correct)
  • By chest compression
  • What is considered to be a contraindication to mediastinoscopy according to the text?

    <p>SVC obstruction</p> Signup and view all the answers

    How is SVC congestion typically controlled in patients according to the text?

    <p>Steroids or diuretics</p> Signup and view all the answers

    What treatment might be scheduled before mediastinoscopy for patients with SVC syndrome?

    <p>Radiation or chemotherapy</p> Signup and view all the answers

    Why is assiduous neuromuscular blockade monitoring particularly important for patients undergoing mediastinoscopy?

    <p>To avoid complications related to anesthesia</p> Signup and view all the answers

    Why should blood be typed and cross-matched for patients undergoing mediastinoscopy?

    <p>To anticipate potential massive hemorrhage complications</p> Signup and view all the answers

    What is the reason for preparing emergency thoracotomy equipment and a plan before mediastinoscopy?

    <p>To manage significant intraoperative blood loss</p> Signup and view all the answers

    Why should fluids be administered through lower extremity intravenous sites for patients with SVC syndrome during mediastinoscopy?

    <p>To reduce the risk of fluid extravasation</p> Signup and view all the answers

    Why is it recommended to place at least one large-bore intravenous catheter before inducing anesthesia for a mediastinoscopy?

    <p>To prepare for potential massive blood loss scenarios</p> Signup and view all the answers

    What complication is specifically mentioned as the most serious associated with mediastinoscopy?

    <p>Massive hemorrhage</p> Signup and view all the answers

    What should be ensured before extubation to reduce the risk of air embolism in patients undergoing spontaneous ventilation?

    <p>Full return of reflexes</p> Signup and view all the answers

    Why is the head of the bed elevated postoperatively for a patient recovering from mediastinoscopy?

    <p>To improve respiratory function</p> Signup and view all the answers

    What can cause respiratory distress in the recovery room post-mediastinoscopy?

    <p>Paratracheal hematoma</p> Signup and view all the answers

    In what circumstance would a patient who underwent mediastinoscopy require immediate reintubation?

    <p>Unilateral recurrent laryngeal nerve damage</p> Signup and view all the answers

    What complication may arise during the recovery period in patients with tracheomalacia post-mediastinoscopy?

    <p>Unexpected airway obstruction</p> Signup and view all the answers

    What is a necessary post-operative monitoring action for a patient recovering from mediastinoscopy in the post anesthesia care unit?

    <p>A chest x-ray to rule out pneumothorax</p> Signup and view all the answers

    What is the primary concern regarding decreasing innominate blood flow during mediastinoscopy?

    <p>Increased risk of cerebral ischemia</p> Signup and view all the answers

    What monitoring technique is recommended to assess blood flow to the right arm during mediastinoscopy?

    <p>Both B and C</p> Signup and view all the answers

    Which positioning consideration is recommended to reduce venous congestion during mediastinoscopy?

    <p>Slight head-up position</p> Signup and view all the answers

    Which statement regarding anesthetic management during mediastinoscopy is false?

    <p>High intrathoracic pressures increase venous return</p> Signup and view all the answers

    What is a key consideration during the induction of anesthesia for a patient with SVC syndrome undergoing mediastinoscopy?

    <p>A slow, controlled induction in the sitting position is often prudent</p> Signup and view all the answers

    Which statement regarding ventilation during mediastinoscopy is correct?

    <p>Controlled ventilation should be adjusted to provide the lowest ventilating pressure compatible with oxygenation and normal end-tidal CO2</p> Signup and view all the answers

    What equipment should be immediately available during mediastinoscopy to manage potential airway emergencies?

    <p>Both A and B</p> Signup and view all the answers

    Which type of endotracheal tube is recommended for mediastinoscopy to minimize the risk of kinking?

    <p>Single-lumen reinforced endotracheal tube</p> Signup and view all the answers

    Which statement regarding intraoperative hemodynamic changes during mediastinoscopy is correct?

    <p>Cardiovascular changes can occur suddenly</p> Signup and view all the answers

    In the event of acute cardiovascular collapse during mediastinoscopy, which maneuver may help relieve symptoms?

    <p>Changing the patient's position</p> Signup and view all the answers

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