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Pituitary

, Volume 22, Issue 2, pp 187–194 | Cite as

Pretreatment with somatostatin analogs does not affect the anesthesiologic management of patients with acromegaly

  • Marco LosaEmail author
  • Carmine Antonio Donofrio
  • Marco Gemma
  • Lina Raffaella Barzaghi
  • Pietro Mortini
Article
  • 44 Downloads

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.

Keywords

Acromegaly Pituitary surgery Pituitary neoplasm Anesthesia Somatostatin analogs 

Notes

Acknowledgements

We thank Dr. Snider for his contribution to the analysis of data obtained from the ICAR.

Funding

This research did not receive any specific Grant from any funding agency in the public, commercial or not-for-profit sector.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pituitary Unit of the Division of Neurosurgery, IRCCS San RaffaeleVita-Salute UniversityMilanItaly
  2. 2.Anesthesia and Intensive Care UnitFatebenefratelli HospitalMilanItaly

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