Anterior mediastinal mass: A dreaded challenge for anaesthesiologistsA case report

Anaesthesia is often required to be administered in patients with mediastinal masses for surgical procedures such as biopsy, staging laparotomy, and others during the course of their treatment. “Mediastinal mass syndrome” (MMS), which results from compression of vital structures in the mediastinal space, can complicate the surgical procedures. A 66-year-old male who was a known case of uncontrolled type-2 diabetes mellitus with hypertension and coronary artery disease under medication presented with severe abdominal pain. A recent computed tomography revealed the extent of the mass. Given the procedure's risk-benefit ratio, segmental spinal-epidural anaesthesia was preferred over general anaesthesia for induction. We conclude that meticulous pre-operative multidisciplinary discussion and assessment, the use of well-planned and newer induction modalities such as segmental spinal, and the following of established protocols for emergencies are all vital to patient safety in major abdominal surgeries like exploratory laparotomy, especially in patients with other co-morbidities.