Anaesthetic management of a pregnant woman with carcinoid disease

Woo, Kathy; Imasogie, Ngozi; Bruni, I.; Singh, Shailendra

doi:10.1016/j.ijoa.2009.01.009

Cited by 7 publications

(2 citation statements)

References 12 publications

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“…There is currently no consensus on the administration modality, however the latest ENETS recommendations (15,19) suggest a bolus of 100mcg at induction followed by a continuous infusion of between 50 and 300 mcg with additional iterative boluses. -The maintenance of adequate multimodal anesthesia and analgesia is essential, the use of remifentanil (20), epidural or spinal block (21)(22)(23) have been described. Also, monitor the quality and depth of anesthesia by means of BIS or EEG in order to discriminate the different possible etiologies of hypertensive attacks that may mimic a carcinoid crisis (24).…”

Section: Discussionmentioning

confidence: 99%

Anesthetic key points in a patient with a terminal ileum neuroendocrine tumor and a rare carcinoid left heart disease presented for non-cardiac surgery. Case Report

Ussel,

Leonard,

Watremez

et al. 2023

Preprint

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Background Carcinoid tumors are rare neuroendocrine malignancies presenting in an increasing number in our center. The incidence of carcinoid tumors is approximatively 1 in 75000 of the population of whom about 50% develop carcinoid syndrome. Once the carcinoid syndrome has developed, a carcinoid cardiomyopathy can occur. Carcinoid heart disease (CaHD) remains a serious and rare complication associated with a significant increase in morbidity and mortality. Although carcinoid tumors have been known and studied for several years, there are still scarce data on the anesthetic management and the per operative period. Case presentation: We describe a case of a Caucasian 44-year-old woman with an unusual presentation of left CaHD with an ileal neuroendocrine tumor and liver metastases. Our preoperative somatostatin administration protocol, limit the cardiac damage. The maintenance of stable hemodynamics, the use of balanced anesthetic technic, all along with a good understanding of the pathology, played a major role in the successful management of anesthesia. This case report allows us to introduce our decision algorithm for the management of this type of pathology in our tertiary hospital, Cliniques Universitaires Saint-Luc. Conclusion Despite the paucity of data, anesthetic management of patients with carcinoid tumor can be safely performed with effective hemodynamic monitoring and a good understanding of the pathophysiology. Knowledge and application of a clear institutional algorithm for octreotide administration and multidisciplinary consultation at a referral center are essential for the management of these patients.

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Section: Discussionmentioning

confidence: 99%

Anesthetic key points in a patient with a terminal ileum neuroendocrine tumor and a rare carcinoid left heart disease presented for non-cardiac surgery. Case Report

Ussel,

Leonard,

Watremez

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…This lady was profoundly fluid deplete and anuric pre-operatively due to a combination of gastrointestinal losses and sepsis, but by the end of the case her haemodynamic parameters were much improved and she was producing urine. It is particularly important that patients with carcinoid syndrome are fluid replete rather than relying on exogenous catecholamines to treat hypotension as evidence suggests they may precipitate a crisis and so actually worsen the situation [9].…”

Section: Discussionmentioning

confidence: 99%