British Journal of Anaesthesia, Vol 84, Issue 2 179-182, Copyright © 2000 by Oxford University Press
PA Seidman, WA Kofke, R Policare and M Young
The anaesthetic risks of acromegaly include difficulties in airway
management, hypertension, and cardiac, gastrointestinal and renal problems.
To estimate the incidence of major complications in this rare group of
patients, we reviewed 28 patients with acromegaly who had pituitary tumour
excision over a 10-yr period. Each patient was matched for age, weight and
sex to a non-acromegalic patient undergoing transsphenoidal pituitary
surgery. Acromegalic patients received significantly more fentanyl and
midazolam and less thiopental and succinylcholine than controls (all P <
0.05). Mean arterial pressure (baseline, minimal and maximal values) was
higher in acromegalic patients than in controls. There was no difference
between groups in the use of vasoactive drugs. PaO2, FIO2 and PaCO2 were
similar in both groups. Arterial pH was significantly lower (P = 0.015),
blood glucose was higher (P < 0.001) and fluid intake minus output was
higher (P = 0.04) in acromegalic patients than in controls. Airway
difficulty and tongue enlargement were encountered more often in
acromegalic patients (P = 0.002 and P = 0.001, respectively). Our data
confirm that in acromegalic patients: airway difficulties occurred more
frequently; severe haemodynamic instability did not typically occur during
surgery for acromegaly; pulmonary gas exchange was not altered during
operation; glucose intolerance may be an intraoperative problem; and fluid
regulation may be altered.
ARTICLES
Anaesthetic complications of acromegaly
Department of Anesthesiology, CCM University of Pittsburgh Medical Center, PA 15261, USA.
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