TY  - CHAP
M1  - Book, Section
TI  - Anesthesia for Patients with Endocrine Disease
A1  - Alexanian, Sara
A1  - Lee, Stephanie L.
A1  - Peterfreund, Robert A.
A2  - Longnecker, David E.
A2  - Mackey, Sean C.
A2  - Newman, Mark F.
A2  - Sandberg, Warren S.
A2  - Zapol, Warren M.
Y1  - 2017
N1  - 
T2  - Anesthesiology, 3e
AB  - KEY  POINTSEndocrine  diseases  are  common  comorbid  conditions  in  surgical  patients.The  patient’s  type  of  diabetes  mellitus  must  be  known  and  the  differing  therapies  for  types  1  and  2  appreciated.Frequent  monitoring  of  glucose  levels  is  a  mainstay  in  management  of  the  diabetic  patient  undergoing  anesthesia  and  surgery.General  anesthesia  may  mask  the  signs  and  symptoms  of  hypoglycemia;  signs  of  hypoglycemia  (tachycardia,  sweating)  may  be  misinterpreted  as  “light  anesthesia”.Tight  perioperative  glucose  control  is  no  longer  generally  recommended.  Consider  keeping  glucose  levels  at  <150-180  mg/dL.Hypothyroid  patients  may  exhibit  sensitivity  to  sedative  and  hypnotic  drugs  used  perioperatively.  Hemodynamic  instability  should  be  anticipated.Hyperthyroid  patients  may  exhibit  dehydration  and  hemodynamic  instability  and  are  at  particular  risk  for  tachydysrhythmias,  metabolic  or  vascular  decompensation,  and  thyroid  storm.The  airway  is  a  key  consideration  in  patients  undergoing  thyroid  surgery.Pheochromocytoma  patients  require  careful  preoperative  preparation,  and  plans  must  be  made  to  monitor  and  manage  hemodynamic  extremes  during  surgery.Glucocorticoid  deficiency  in  patients  at  risk  for  adrenal  insufficiency  should  be  anticipated.  Consider  careful  titration  of  supplemental  steroid  therapy.The  implications  of  growth  hormone  excess  (acromegaly)  and  adrenal  steroid  excess  (Cushing  disease)  should  be  considered  when  preparing  patients  for  pituitary  surgery.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/16
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1144132152
ER  -