A Patient with Cushing’s Disease for Pituitary Tumor Resection: Anesthetic Challenges and Management

Authors

  •   Renu Bala Departments of Anaesthesiology and Critical Care, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana
  •   Garima Vashisht Departments of Anaesthesiology and Critical Care, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana
  •   Ishwar Singh Neurosurgery, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana
  •   Saquib Siddique Neurosurgery, Pt. B. D. Sharma Postgraduate Institute of Medical Sciences, Rohtak, Haryana

Keywords:

Anesthesia, Cushing’s disease, pituitary gland, transsphenoidal surgery

Abstract

Adrenocorticotrophic hormone‑secreting pituitary adenoma is though quite rare yet carries significant mortality and morbidity due to severe comorbidities associated with them. Transsphenoidal resection of pituitary adenoma is the treatment of choice. While managing these patients, anesthesiologists face hosts of challenges since there are significant alterations in pathophysiology of the body. A thorough understanding of preoperative assessment, intraoperative management, and potential complications is fundamental for successful perioperative outcome. We report a case of Cushing’s disease who underwent pituitary tumor resection and discuss the difficulties encountered and their management.

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Published

2017-10-01

How to Cite

Bala, R., Vashisht, G., Singh, I., & Siddique, S. (2017). A Patient with Cushing’s Disease for Pituitary Tumor Resection: Anesthetic Challenges and Management. Karnataka Anaesthesia Journal, 3(4), 79–81. Retrieved from http://karnatakaanesthesiajournal.in/index.php/kaj/article/view/138960

References

Horvat A, Kolak J, Gopcević A, Ilej M, Zivko G. Anesthetic management of patients undergoing pituitary surgery. Acta Clin Croat 2011;50:209‑16.

Nemergut EC, Dumont AS, Barry UT, Laws ER. Perioperative management of patients undergoing transsphenoidal pituitary surgery.Anesth Analg 2005;101:1170‑81.

Smith M, Hirsch NP. Pituitary disease and anaesthesia. Br J Anaesth 2000;85:3‑14.

Pivonello R, Leo MD, Cozzolino A, Calao A. The treatment of Cushing disease. Endocrinol Rev 2015;36:385‑486.

Mehta GU, Lonser RR, Oldfield EH. The history of pituitary surgery for Cushing disease. J Neurosurg 2012;116:261‑8.

Sharma ST, Nieman LK, Feelders RA. Comorbidities in Cushing’s disease. Pituitary 2015;18:188‑94.

Fahlbusch R, Buchfilder M, Muller OA. Transsphenoidal surgery for Cushing disease. J R Soc Med 1986;79:262‑9.

Rollin G, Ferreira NP, Czepielewski MA. Prospective evaluation of transsphenoidal pituitary surgery in 108 patients with Cushing’s disease.Arq Bras Endocrinol Metabol 2007;51:1355‑61.

Domi R. Cushing surgery: Role of anesthesiologists. Indian J Endocrinol Metab 2011;15:5322‑8.

Saffin AP, Thomas T. Anaesthetic management of laparoscopic assisted bilateral adrenelectomy in a five year old child with Cushing disease.S Afr J Anaesth Analg 2011;17:396‑9.

Malhotra SK, Sharma K, Saini V. Pituitary surgery and anaesthetic management: An update. World J Endoc Surg 2013;5:1‑5.

Gopalakrishna KN, Dash PK, Chatterjee N, Easwer HV, Ganesamoorthi A. Dexmedetomidine as an anesthetic adjuvant in patients undergoing transsphenoidal resection of pituitary tumor. J Neurosurg Anesthesiol 2015;27:209‑15.

Chee GH, Mathias DB, James RA, Kendall‑Taylor P. Transsphenoidal pituitary surgery in Cushing’s disease: Can we predict outcome? Clin Endocrinol (Oxf) 2001;54:617‑26.

Lim M, Williams D, Maartens N. Anaesthesia for pituitary surgery. J Clin Neurosci 2006;13:413‑8.