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- W22093333 abstract "This chapter describes the anesthetic considerations in endocrine surgery. The usual approach to these tumors is transnasal–transsphenoidal. The patient is intubated, mechanically ventilated, and rendered slightly hypocarbic and moderately hypotensive. The preferred position for surgery is prone with the head turned to the operative side. The airway must be protected from nasal bleeding by pharyngeal packs. Intravenous access with a large cannula is needed as is monitoring of ECG, systemic blood pressure, pulse oximetry, and end-tidal carbon dioxide. Arterial and central venous pressure monitoring is dictated by the condition of the patient. Craniotomy with the retraction of frontal lobes may be elected for large tumors, and this is the province of neurosurgical anesthesia. Anterior lobe adenomas secreting ACTH or growth hormone are the two main endocrine indications for transsphenoidal or transfrontal sinus surgery. The encroachment of a pituitary tumor on the functioning hypophysis can cause partial or complete hypopituitarism requiring a perioperative replacement of thyroxine and glucocorticoids. Although anesthesia and surgery cause appreciable rises in adrenal steroids, there is no evidence that patients with Cushing's syndrome are adversely affected by specific premedications or anesthetic agents." @default.
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- W22093333 date "1993-01-01" @default.
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- W22093333 title "Anaesthetic Considerations in Endocrine Surgery" @default.
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