Anaesthetic management of a child with mediastinal tumour, superior vena caval obstruction and thrombocytopenia

Abstract

A 4 year old girl presented with swelling of left half of face, fever, hurried breathing and a mass over the left forearm. A computerised tomography (CT) scan revealed a large mediastinal mass compressing the superior vena cava, encasing trachea, both main bronchi and pulmonary trunk with infiltration into left upper lobe of lung. Haematological investigations revealed anaemia and thrombocytopenia. As part of clinical evaluation, she was posted for left ulnar mass biopsy. The case was successfully managed with an ultrasound guided brachial plexus block without any respiratory or haemodynamic compromise.