Bajwa Sukhminderjit Singh, Bajwa Sukhwinder Kaur
Departments of Anesthesiology and Intensive Care, Gian Sagar Medical College and Hospital, Ram Nagar, Banur, Punjab, India.
Indian J Endocrinol Metab. 2011 Sep;15 Suppl 3(Suppl3):S224-32. doi: 10.4103/2230-8210.84872.
The advancements in neuro-endocrine surgical interventions have been well supported by similar advancements in anesthesiology and intensive care. Surgery of the pituitary tumor poses unique challenges to the anesthesiologists and the intensivists as it involves the principles and practices of both endocrine and neurosurgical management. A multidisciplinary approach involving the endocrine surgeon, neurosurgeon, anesthesiologist, endocrinologist and intensivist is mandatory for a successful surgical outcome. The focus of pre-anesthetic checkup is mainly directed at the endocrinological manifestations of pituitary hypo or hyper-secretion as it secretes a variety of essential hormones, and also any pathological state that can cause imbalance of pituitary secretions. The pathophysiological aspects associated with pituitary tumors mandate a thorough airway, cardiovascular, neurologic and endocrinological assessment. A meticulous preoperative preparation and definite plans for the intra-operative period are the important clinical components of the anesthetic strategy. Various anesthetic modalities and drugs can be useful to provide a smooth intra-operative period by countering any complication and thus providing an uneventful recovery period.
神经内分泌外科干预的进展得到了麻醉学和重症监护领域类似进展的有力支持。垂体肿瘤手术给麻醉医生和重症医生带来了独特的挑战，因为它涉及内分泌和神经外科管理的原则与实践。成功的手术结果需要内分泌外科医生、神经外科医生、麻醉医生、内分泌学家和重症医生的多学科方法。麻醉前检查的重点主要针对垂体分泌不足或分泌过多的内分泌表现，因为垂体会分泌多种重要激素，同时也针对任何可能导致垂体分泌失衡的病理状态。与垂体肿瘤相关的病理生理学方面要求进行全面的气道、心血管、神经和内分泌评估。精心的术前准备和明确的术中计划是麻醉策略的重要临床组成部分。各种麻醉方式和药物有助于通过应对任何并发症来提供平稳的手术过程，从而实现顺利的恢复期。
