RESEARCH ARTICLE
The use of “High Dose” Dexmedetomidine in a Patient with Critical Tracheal Stenosis and Anterior Mediastinal Mass
C. Voscopoulos1, 2, F.L. Kirk1, M. Lovrincevic1, M. Lema1, *
Article Information
Identifiers and Pagination:
Year: 2011Volume: 5
First Page: 42
Last Page: 49
Publisher ID: TOATJ-5-42
DOI: 10.2174/1874321801105010042
Article History:
Received Date: 10/10/2011Revision Received Date: 10/11/2011
Acceptance Date: 11/11/2011
Electronic publication date: 30/11/2011
Collection year: 2011
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
The anterior medial mass patient continues to offer great challenges for the anesthesiologist. As such, newer and safer methods of providing anesthetic care are continually being sought. To this end, there is a growing body of evidence that may suggest that higher than Food and Drug Administration approved dosages of dexmedetomidine may offer another option in the arsenal of the anesthesiologist in this patient population.
We recently cared for a middle aged male who presented with a large mediastinal mass, extrinsic compression critical tracheal stenosis, superior vena cava syndrome, and massive supraclavicular lymphadenopathy, scheduled for tracheal stent placement, biopsy, and diagnostic evaluation of the esophagus. After reviewing anesthetic options, we deemed the safest technique available to us to be the use of a high dose dexmedetomidine based technique with continuous infusion rate of 2mcg/kg/hr. Spontaneous respirations were maintained throughout the case, with a stable heart rate and blood pressure, and our patient tolerated the procedure without complications.
