Marco Losa1, Carmine Antonio Donofrio2, Marco Gemma3, Lina Raffaella Barzaghi2, Pietro Mortini2. 1. Pituitary Unit of the Division of Neurosurgery, IRCCS San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy. losa.marco@hsr.it. 2. Pituitary Unit of the Division of Neurosurgery, IRCCS San Raffaele, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy. 3. Anesthesia and Intensive Care Unit, Fatebenefratelli Hospital, Milan, Italy.
Abstract
PURPOSE: Acromegaly may be associated with an increased risk of complex intraoperative management and anesthetic complications. No study addressed whether pretreatment with somatostatin receptor ligands (SRLs) affects anesthesiologic management. METHODS: We studied 211 consecutive acromegalic patients who had a recorded intraoperative computerized anesthetic record (ICAR) available for analysis. Ninety-six (45.5%) patients were SRL-pretreated while 115 patients were treatment naïve. RESULTS: Treatment with SRLs reduced mean basal growth hormone level from 23.8 ± 4.2 to 5.9 ± 1.3 µg/L. Normalization of insulin-like growth factor-1 was achieved in 26 patients (27.1%). The frequency of comorbidities at surgery was similar in the two groups. Five patients with difficult intubation were naïve (4.3%) as compared with 5 SRL-pretreated patients (5.2%; P = 1.0). ICAR registration did not show any significant change of intraoperative vital parameters in the two groups of patients as well as in the intraoperative utilization of drugs. Total duration of anesthesia and surgery were similar in the two groups. Four patients with an intraoperative adverse event were naïve (3.5%) as compared with 4 SRL-pretreated patients (4.2%; P = 1.00). Remission of disease occurred in 83 of 114 naïve patients (72.8%) and in 57 of 93 SRL-pretreated patients (61.3%; P = 0.11). CONCLUSIONS: SRL-pretreatment of patients with acromegaly had no significant impact on intraoperative anesthesiologic management. Despite a better Cormack-Lehane score in SRL-pretreated than in naïve patients, the rate of difficult intubation was similar in both groups. SRL-pretreatment did not affect the rate of surgical remission or complications as well.
PURPOSE:Acromegaly may be associated with an increased risk of complex intraoperative management and anesthetic complications. No study addressed whether pretreatment with somatostatin receptor ligands (SRLs) affects anesthesiologic management. METHODS: We studied 211 consecutive acromegalicpatients who had a recorded intraoperative computerized anesthetic record (ICAR) available for analysis. Ninety-six (45.5%) patients were SRL-pretreated while 115 patients were treatment naïve. RESULTS: Treatment with SRLs reduced mean basal growth hormone level from 23.8 ± 4.2 to 5.9 ± 1.3 µg/L. Normalization of insulin-like growth factor-1 was achieved in 26 patients (27.1%). The frequency of comorbidities at surgery was similar in the two groups. Five patients with difficult intubation were naïve (4.3%) as compared with 5 SRL-pretreated patients (5.2%; P = 1.0). ICAR registration did not show any significant change of intraoperative vital parameters in the two groups of patients as well as in the intraoperative utilization of drugs. Total duration of anesthesia and surgery were similar in the two groups. Four patients with an intraoperative adverse event were naïve (3.5%) as compared with 4 SRL-pretreated patients (4.2%; P = 1.00). Remission of disease occurred in 83 of 114 naïve patients (72.8%) and in 57 of 93 SRL-pretreated patients (61.3%; P = 0.11). CONCLUSIONS: SRL-pretreatment of patients with acromegaly had no significant impact on intraoperative anesthesiologic management. Despite a better Cormack-Lehane score in SRL-pretreated than in naïve patients, the rate of difficult intubation was similar in both groups. SRL-pretreatment did not affect the rate of surgical remission or complications as well.
Authors: Renato Cozzi; Maria R Ambrosio; Roberto Attanasio; Alessandro Bozzao; Laura De Marinis; Ernesto De Menis; Edoardo Guastamacchia; Andrea Lania; Giovanni Lasio; Francesco Logoluso; Pietro Maffei; Maurizio Poggi; Vincenzo Toscano; Michele Zini; Philippe Chanson; Laurence Katznelson Journal: Endocr Metab Immune Disord Drug Targets Date: 2020 Impact factor: 2.895
Authors: David Netuka; André Grotenhuis; Nicolas Foroglou; Francesco Zenga; Sebastien Froehlich; Florian Ringel; Nicolas Sampron; Nick Thomas; Martin Komarc; Mikuláš Kosák; Martin Májovský Journal: Sci Rep Date: 2022-04-20 Impact factor: 4.996