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General Anesthesia in a patient with a lung carcinoid tumor with hepatic and bone metastases: a case report

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Resumo:Introduction: Carcinoid tumors have the potential to metastasize and the ability to secrete bioactive substances. Carcinoid crisis is a serious event that may be triggered during anesthesia. It is a challenge to the anesthesiologist because it can provoke oscillations of blood pressure, flushing, bronchospasm and arrhythmias. Case Report: We report our anesthetic management of a 63-year-old male with a lung carcinoid tumor with liver and bone metastases that was submitted to surgical correction of bilateral inguinal hernia. Octreotide infusion was initiated at 25 µg/h preoperatively and was maintained for 24 hours after the surgery. There were no complications, with hemodynamic and ventilatory stability. Discussion: Carcinoid crisis is a life-threatening complication. The anesthesiologist must focus on preventing stressful situations that can provoke the release of bioactive substances. Octreotide is the drug of choice to prevent and treat carcinoid crisis and should be readily available for patients with carcinoid tumors.
Autores principais:Fernandes, Mariana
Assunto:Case Report
Ano:2022
País:Portugal
Tipo de documento:artigo
Tipo de acesso:acesso aberto
Instituição associada:Sociedade Portuguesa de Anestesiologia
Idioma:inglês
Origem:Revista da Sociedade Portuguesa de Anestesiologia
Descrição
Resumo:Introduction: Carcinoid tumors have the potential to metastasize and the ability to secrete bioactive substances. Carcinoid crisis is a serious event that may be triggered during anesthesia. It is a challenge to the anesthesiologist because it can provoke oscillations of blood pressure, flushing, bronchospasm and arrhythmias. Case Report: We report our anesthetic management of a 63-year-old male with a lung carcinoid tumor with liver and bone metastases that was submitted to surgical correction of bilateral inguinal hernia. Octreotide infusion was initiated at 25 µg/h preoperatively and was maintained for 24 hours after the surgery. There were no complications, with hemodynamic and ventilatory stability. Discussion: Carcinoid crisis is a life-threatening complication. The anesthesiologist must focus on preventing stressful situations that can provoke the release of bioactive substances. Octreotide is the drug of choice to prevent and treat carcinoid crisis and should be readily available for patients with carcinoid tumors.