Abstract:

Aim: Anesthesia management of acromegalic patients undergoing tumor resection with endoscopic transsphenoidal surgery requires special attention and approach due to the accompanying endocrinological and anatomical anamolies. In this retrospective study, we aimed to address anesthesia management and perioperative care in patients undergoing transsphenoidal pituitary surgery with the diagnosis of acromegaly. Material and Methods: After obtaining approval from the Institutional Investigation and Ethics Committee of our university, between January 2017 and December 2018, 25 acromegalic patients with endoscopic transsphenoidal surgery underwent pituitary tumor excision were retrospectively analyzed by using written and online files and anesthesia records. Results: The majority of patients presented with complaints of excessive hormone secretion. Common symptoms were somatic dysmorphicity, headache and visual field defects. Difficult mask ventilation was developed in 3 patients and difficult intubation in 2 patients. One of the difficult intubation case was intubated with awake fiberoptic bronchoscope and the other patient was with videolaryngoscope. Conclusion: Surgery of acromegalic patients may involve several anesthetic difficulties due to many airway problems, heart and metabolic risk factors. Anesthesiologists should be familiar with the various presentations of pituitary disease and its effects on the perioperative status of the patient.

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