[Anesthetic Management for Reconstruction of the Superior Vena Cava by Monitoring of Peripheral Venous Pressure in a Patient with a Mediastinum Tumor]

A 26-years-old man with a giant mediastinum tumor was scheduled for reconstruction of the superior vena cave and tumor resection. Anesthetic management for reconstruction of the superior vena cava was performed by monitoring of peripheral venous pressure. A bypass between the inominate vein and right auricula was made by using an artificial vessel before clamping the superior vena cava. When the superior vena cava was clamped, peripheral venous pressure increased suddenly to 42 mmHg. Immediately after the venesection from the peripheral vessel, it was possible to control peripheral venous pressure at about 20 mmHg. Blood was re-transfused from the femoral vein to the patient. Cerebral neurological symptom due to the increasing venous pressure was not detected. In conclusion, monitoring peripheral venous pressure during reconstruction of the superior vena cava in a patient with a mediastinum tumor may be a useful technique.