Anesthetic aspects of the resection of hormone-active carotid chemodectomas: a clinical case and literature review
https://doi.org/10.21292/2078-5658-2020-17-5-95-105
Abstract
The article describes a clinical case - the resection of the hormone- active tumor of the carotid glomus. The hormonal activity of the tumor was suspected based on data of the patient's history, (malignant arterial hypertension with sharp rises in arterial tension, episodes of the increased arterial tension during mechanical impact on the tumor) and hemodynamic parameters during surgery (heart rhythm disturbances after induction of anesthesia and pronounced hypertensive reactions when manipulating the tumor tissue). The article reviews publications on anesthetic support during the resection of hormone-active chemodectomas.
Detection of typical clinical signs such as hypertension, tachycardia, fever, headaches, etc. in the history of patients with chemodectoma may suggest hormonal activity of the tumor. Biochemical tests that determine the level of catecholamines and their breakdown products can confirm the diagnosis. When planning surgery, the anesthesiologist should be prepared for the development of the relevant complications. Hypertension, as the most frequent complication, should be prevented by preoperative adrenergic blockers and treated intraoperatively with short-acting antihypertensive drugs. After exclusion of the tumor from the bloodstream, it is necessary to prepare for the development of hypotension.
About the Authors
A. A. Kurbasov
N. N. Burdenko National Scientific and Practical Center for Neurosurgery
Russian Federation
Russian Federation
Aleksandr A. Kurbasov Resident Physician of Anesthesiology and Intensive Care Department
16, 4th Tverskaya-Yamskaya St., Moscow, 125047
Phone: +7 (499) 972‒86‒68
A. V. Shmigelskiy
N. N. Burdenko National Scientific and Practical Center for Neurosurgery
Russian Federation
Russian Federation
Aleksandr V. Shmigelskiy Doctor of Medical Sciences, Professor
16, 4th Tverskaya-Yamskaya St., Moscow, 125047
Phone: +7 (499) 972‒86‒68
A. D. Аkhmedov
N. N. Burdenko National Scientific and Practical Center for Neurosurgery
Russian Federation
Russian Federation
Ayaz D. Аkhmedov Candidate of Medical Sciences
16, 4th Tverskaya-Yamskaya St., Moscow, 125047
Phone: +7 (499) 972‒86‒68
V. A. Lukshin
N. N. Burdenko National Scientific and Practical Center for Neurosurgery
Russian Federation
Russian Federation
Vasiliy A. Lukshin Doctor of Medical Sciences, Associate Professor
16, 4th Tverskaya-Yamskaya St., Moscow, 125047
Phone: +7 (499) 972‒86‒68
D. Yu. Usachev
N. N. Burdenko National Scientific and Practical Center for Neurosurgery
Russian Federation
Russian Federation
Dmitry Yu. Usachev Doctor of Medical Sciences, Professor, Correspondent Member of the Russian Academy of Sciences
16, 4th Tverskaya-Yamskaya St., Moscow, 125047
Phone: +7 (499) 972‒86‒68
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Review
For citations:
Kurbasov A.A., Shmigelskiy A.V., Аkhmedov A.D., Lukshin V.A., Usachev D.Yu. Anesthetic aspects of the resection of hormone-active carotid chemodectomas: a clinical case and literature review. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2020;17(5):95-105. (In Russ.) https://doi.org/10.21292/2078-5658-2020-17-5-95-105
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