Retrospective analysis of anesthesia management in endoscopic transsphenoidal pituitary surgery

INTRODUCTION: Endoscopic transsphenoidal resection of pituitary masses has been preferred by surgeons with increasing frequency in recent years. Anesthesia management for this surgery has unique challenges, requiring special pre-anesthesia preparation and perioperative management.
METHODS: After the approval of the ethics committee, anesthesia follow-up forms and electronic records of 34 patients were retrospectively reviewed. Demographic characteristics of the patients, comorbidities, American Society of Anesthesiologist score, presence of acromegaly, cushing, prolactinoma, presence of intubation difficulty, duration of anesthesia, hypertension, hypotension, bleeding, and similar complications were recorded.
RESULTS: Of the patients included in the study, 20 (58.8%) were female and 14 (41.2%) were male. The mean age was 46.7±16.38. The average duration of anesthesia was 200.7±37.80 minutes. Of the patients 16 (47.1%) had secretory adenoma, eight patients had acromegaly, four patients had cushings, and four patients had prolactinoma. Difficult airway was observed in a total of six patients.
DISCUSSION AND CONCLUSION: Hypo or hypersecretion of pituitary hormones can cause problems affecting anesthesia. Before the operation, patients should be evaluated in detail by a multidisciplinary team working in harmony with anesthesiologist, endocrinologist and neurosurgeon, and appropriate treatments should be initiated. Appropriate anesthesia method and strict perioperative observation are essential for successful endoscopic surgery, providing early recovery and a soft awakening.