Abstract
The pituitary gland is located in the sella turcica at the base of the brain, in close proximity to the sphenoid sinus, hypothalamus, optic chiasm, and vessels. Anesthesia for pituitary surgery involves problems related to surgical intervention and preexisting dysfunction/changes in the endocrine system of patients. Removal of pituitary adenomas in patients with Cushing’s disease or acromegaly is best done by endoscopic transnasal and transsphenoidal microsurgery while preserving anterior pituitary function in most patients. Serious complications may occur with respect to the airway, hormonal dysfunction (diabetes insipidus), serum electrolyte disturbances, CSF leakage, and visual fields, just to name a few, during/after anesthesia and surgery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Ali Z, Prabhakar H, Bithal PK, Dash HH. Bispectral index-guided administration of anesthesia for transsphenoidal resection of pituitary tumors: a comparison of 3 anesthetic techniques. J Neurosurg Anesthesiol. 2009;21:10–5.
Ammirati M, Wei L, Ciric I. Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry. 2013;84:843–9.
Atkinson JL, Young WF Jr, Meyer FB, Davis DH, Nippoldt TB, Erickson D, et al. Sublabial transseptal vs transnasal combined endoscopic microsurgery in patients with Cushing disease and MRI-depicted microadenomas. Mayo Clin Proc. 2008;83:550–3.
Burkhardt T, Rotermund R, Schmidt NO, Kiefmann R, Flitsch J. Dexamethasone PONV prophylaxis alters the hypothalamic-pituitary-adrenal axis after transsphenoidal pituitary surgery. J Neurosurg Anesthesiol. 2014;26:216–9.
Dinsmore J. Anaesthesia for elective neurosurgery. Br J Anaesth. 2007;99:68–74.
Dunn LK, Nemergut EC. Anesthesia for transsphenoidal pituitary surgery. Curr Opin Anaesthesiol. 2013;26:549–54.
Gondim JA, Almeida JP, de Albuquerque LA, Gomes E, Schops M, Mota JI. Endoscopic endonasal transsphenoidal surgery in elderly patients with pituitary adenomas. J Neurosurg. 2015;123:31–8.
Nemergut EC, Zuo Z. Airway management in patients with pituitary disease: a review of 746 patients. J Neurosurg Anesthesiol. 2006;18:73–7.
Ovassapian A, Doka JC, Romsa DE. Acromegaly-uses of fiberoptic laryngoscopy to avoid tracheostomy. Anesthesiology. 1981;54:429–30.
Schmitt H, Buchfelder M, Radespiel-Tröger M, Fahlbusch R. Difficult intubation in acromegalic patients: incidence and predictability. Anesthesiology. 2000;93:110–4.
The Committee of Brain Tumor Registry of Japan. Report of brain tumor registry of Japan (1969–1993) 10th edition. Neurol Med Chir. 2000;40:1–102.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Dohi, S. (2020). Perioperative Challenges During Pituitary Surgery. In: Brambrink, A., Kirsch, J. (eds) Essentials of Neurosurgical Anesthesia & Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-17410-1_33
Download citation
DOI: https://doi.org/10.1007/978-3-030-17410-1_33
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-17408-8
Online ISBN: 978-3-030-17410-1
eBook Packages: MedicineMedicine (R0)