For patients with carcinoid syndrome undergoing surgery, effective anesthetic management is crucial. It's important for the endocrinologist, anesthetist, and surgeon to communicate and collaborate closely. The primary aim during anesthesia for carcinoid surgery is to maintain stable and controlled conditions while avoiding triggers.

General anesthesia is commonly preferred to avoid the sympathectomy associated with neuraxial anesthesia. However, it's worth noting that epidural and spinal anesthesia have shown success in noncarcinoid surgeries.

Symptoms such as flushing and diarrhea can be managed with medications like octreotide, chlorpromazine, or antihistamines. During the maintenance of anesthesia, the use of positive pressure ventilation, inhalation agents, neuromuscular blocking agents, and opioids should be carefully managed.

Special care must be taken to prevent carcinoid crises, which can be triggered by physical manipulation of the tumor or stimulation. Overall, successful anesthetic management of patients with carcinoid syndrome requires a tailored approach that considers the unique characteristics of the condition.

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Sources

Anesthesia for patients with carcinoid syndrome - PubMedCarcinoid: the disease and its implications for anaesthesia - Oxford AcademicManagement of bronchial carcinoid: An anaesthetic challenge - PMC - NCBICarcinoid syndrome and perioperative anesthetic considerations - ScienceDirect.comCarcinoid Syndrome - OpenAnesthesiaAnesthesia Considerations for Carcinoid

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