28 Questions
Which type of tumors are most likely to produce SVC compression according to the text?
Oat-cell carcinoma
What symptoms may patients with SVC obstruction present with?
Tongue swelling and upper airway edema
How can symptoms of SVC obstruction be relieved?
By head elevation
What is considered to be a contraindication to mediastinoscopy according to the text?
SVC obstruction
How is SVC congestion typically controlled in patients according to the text?
Steroids or diuretics
What treatment might be scheduled before mediastinoscopy for patients with SVC syndrome?
Radiation or chemotherapy
Why is assiduous neuromuscular blockade monitoring particularly important for patients undergoing mediastinoscopy?
To avoid complications related to anesthesia
Why should blood be typed and cross-matched for patients undergoing mediastinoscopy?
To anticipate potential massive hemorrhage complications
What is the reason for preparing emergency thoracotomy equipment and a plan before mediastinoscopy?
To manage significant intraoperative blood loss
Why should fluids be administered through lower extremity intravenous sites for patients with SVC syndrome during mediastinoscopy?
To reduce the risk of fluid extravasation
Why is it recommended to place at least one large-bore intravenous catheter before inducing anesthesia for a mediastinoscopy?
To prepare for potential massive blood loss scenarios
What complication is specifically mentioned as the most serious associated with mediastinoscopy?
Massive hemorrhage
What should be ensured before extubation to reduce the risk of air embolism in patients undergoing spontaneous ventilation?
Full return of reflexes
Why is the head of the bed elevated postoperatively for a patient recovering from mediastinoscopy?
To improve respiratory function
What can cause respiratory distress in the recovery room post-mediastinoscopy?
Paratracheal hematoma
In what circumstance would a patient who underwent mediastinoscopy require immediate reintubation?
Unilateral recurrent laryngeal nerve damage
What complication may arise during the recovery period in patients with tracheomalacia post-mediastinoscopy?
Unexpected airway obstruction
What is a necessary post-operative monitoring action for a patient recovering from mediastinoscopy in the post anesthesia care unit?
A chest x-ray to rule out pneumothorax
What is the primary concern regarding decreasing innominate blood flow during mediastinoscopy?
Increased risk of cerebral ischemia
What monitoring technique is recommended to assess blood flow to the right arm during mediastinoscopy?
Both B and C
Which positioning consideration is recommended to reduce venous congestion during mediastinoscopy?
Slight head-up position
Which statement regarding anesthetic management during mediastinoscopy is false?
High intrathoracic pressures increase venous return
What is a key consideration during the induction of anesthesia for a patient with SVC syndrome undergoing mediastinoscopy?
A slow, controlled induction in the sitting position is often prudent
Which statement regarding ventilation during mediastinoscopy is correct?
Controlled ventilation should be adjusted to provide the lowest ventilating pressure compatible with oxygenation and normal end-tidal CO2
What equipment should be immediately available during mediastinoscopy to manage potential airway emergencies?
Both A and B
Which type of endotracheal tube is recommended for mediastinoscopy to minimize the risk of kinking?
Single-lumen reinforced endotracheal tube
Which statement regarding intraoperative hemodynamic changes during mediastinoscopy is correct?
Cardiovascular changes can occur suddenly
In the event of acute cardiovascular collapse during mediastinoscopy, which maneuver may help relieve symptoms?
Changing the patient's position
Learn about the anesthetic implications associated with Superior Vena Cava (SVC) syndrome, often caused by compression from mediastinal masses, typically seen in lung cancer patients. Understand how obstruction of the SVC can affect venous drainage and result in symptoms like dyspnea and dilated veins.
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