Several uncommon pediatric diseases encountered by non-pediatric
anesthesiologists bear discussion because a failure to recognize unique issues relating
to them could lead to significant morbidity and mortality. Anterior mediastinal masses
share the same space as major pulmonary and cardiovascular structures, which, if
compressed, can compromise the airway, heart and great vessels. Awareness of the
potential for major physiologic derangement and a multidisciplinary approach to their
diagnosis and management will ensure a safe perioperative course. Congenital
pulmonary airway malformation is one of the most frequent pulmonary malformations
in children that requires surgical intervention by thoracoscopic approach in the first
year of life. Their anesthetic management is often challenging due to their small size,
need for lung isolation and maintaining adequate oxygenation during surgery.
Understanding lung isolation technique in infants is necessary for the safe
administration of anesthetics in these children. Arthrogryposis multiplex congenita
syndrome is a rare, non-progressive, and congenital heterogeneous group of disorders
characterized by congenital joint contractures. These children require frequent surgeries
during childhood to address various musculoskeletal abnormalities. Their anesthetic
management is often challenging due to comorbidities related to musculoskeletal
deformities, neurologic, cardiovascular and respiratory systems involvement.
Understanding the disease with thorough evaluation and preparation prior to anesthetic
management is essential for a good perioperative outcome. Pheochromocytoma is a
rare neuroendocrine tumor in children that may present unexpectedly for the
management by anesthesiologists. It secretes catecholamines which can cause lifethreatening perioperative hemodynamic instability. The meticulous preoperative
pharmacotherapy, intraoperative anesthetic management and postoperative monitoring
are vital for a safe outcome.
Keywords: Adolescent, Alpha blocker, Anterior mediastinal mass, Arthrogryposis multiplex congenita, Beta blocker, Bronchial compression, Catecholamines, Congenital pulmonary airway malformation, Congenital lung lesion, Contractures, Difficult intubation, Hyperthermia, Infant, Limb deformities, Lymphoma, One lung ventilation, Pediatric, Pheochromocytoma, Superior vena cava syndrome, Teratoma, Thoracoscopic surgery.
