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 (C)</p> Signup and view all the answers

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

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

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

<p>Radiation or chemotherapy (D)</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 (D)</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 (B)</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 (C)</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 (B)</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 (B)</p> Signup and view all the answers

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

<p>Massive hemorrhage (A)</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 (C)</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 (A)</p> Signup and view all the answers

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

<p>Paratracheal hematoma (B)</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 (D)</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 (C)</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 (B)</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 (C)</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 (B)</p> Signup and view all the answers

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

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

Which statement regarding anesthetic management during mediastinoscopy is false?

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

Which statement regarding intraoperative hemodynamic changes during mediastinoscopy is correct?

<p>Cardiovascular changes can occur suddenly (A)</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 (C)</p> Signup and view all the answers

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