RT Book, Section 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. SR Print(0) ID 1144132152 T1 Anesthesia for Patients with Endocrine Disease T2 Anesthesiology, 3e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071848817 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1144132152 RD 2024/03/29 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.