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BJA Advance Access published online on March 19, 2004
British Journal of Anaesthesia, doi:10.1093/bja/aeh135
© 2004 by The Board of Management and Trustees of the British Journal of Anaesthesia
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Accepted January 22, 2004

Case Report

Remifentanil and anaesthesia for carcinoid syndrome

P. A. Farling 1* A. K. Durairaju 1

1 Department of Anaesthesia, Royal Victoria Hospital, Belfast BT12 6BA, UK

* To whom correspondence should be addressed. E-mail: peter.farling{at}dnet.co.uk.


  Abstract

Carcinoid syndrome creates many challenges during anaesthesia, including hypertension, hypotension and bronchospasm. These challenges are less common and less severe after the routine use of octreotide. We describe the use of remifentanil as part of the anaesthetic management of a 67-yr-old man undergoing resection of a carcinoid tumour of the terminal ileum. The combination of perioperative octreotide administration, intraoperative remifentanil infusion and sevoflurane anaesthesia, with postoperative epidural analgesia proved satisfactory. We review the recent literature and suggest that remifentanil is a useful addition to the armamentarium of the anaesthetist in the management of a patient with carcinoid syndrome.

Keywords: Keywords: anaesthetics opioid, remifentanil; anaesthetic techniques, epidural; metabolism, endocrine, carcinoid; surgery, small bowel resection


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