British Journal of Anaesthesia, 2000, Vol. 85, No. 5 800-802
© 2000 The Board of Management and Trustees of the British Journal of Anaesthesia
Perioperative management of a patient requiring surgery for pituitary apoplexy and severe angina pectoris
Department of Anesthesia, Nagahama City Hospital, 313 Ohinui-cho, Nagahama, Shiga, 526-8580, Japan
We describe the management of a 71-yr-old man with pituitary apoplexy and severe angina pectoris who underwent treatment of an intra-cranial haemorrhage and open-heart surgery requiring anticoagulant therapy within a very short period. Subtotal removal of the pituitary tumour was undertaken under stable cardiovascular conditions. But ventricular fibrillation occurred after the neurosurgery in the intensive care unit. After the patient was defibrillated, intra-aortic balloon pumping was necessary to assist coronary artery blood flow. Twenty hours after neurosurgery, oozing from the surgical wound stopped and coronary artery bypass grafting with full heparinization was performed uneventfully.
Br J Anaesth 2000; 85: 8002