Perioperative Endocrine Management Of Pituitary Tumors
Perioperative Endocrine Management Of Pituitary Tumors
Mahshid Babaei M.D.
Endocrinologist
98.4.13
- Pre- op assessment
- Adrenal insufficiency
- Post-op assessment
- Patients with pituitary disease present unique challenges to the anesthesiologist secondary to the prominent role of the pituitary gland in the endocrine system.
- Successful surgical management of patients harboring pituitary tumors requires a multidisciplinary approach and is critically dependent on the quality of perioperative care.
Preoperative management
- a complete medical history & physical exam
- formal neuro-ophthalmologic assessment with formal visual field testing if the MRI shows evidence that the tumor is abutting or compressing the optic chiasm
- evaluation for potential medical comorbidities:
- a complete blood count
- A metabolic panel to evaluate possible
hyponatremia(adrenal –thyroid- post.pit),
hypercalcemia (MEN-1)
hyperglycemia, and other metabolic abnormalities
- Cardiovascular and respiratory disease
- Hormone hypersecretion
- Hormone defficiency
- Baseline endocrine studies should include:
- HPA axis evaluation
- Free thyroxine (FT4), TSH
- Prolactin (neat and diluted)
- LH,FSH(alfa subunit), testosterone (men)
- Insulin like growth factor-1 (IGF-1)
