Is there any special anaesthetic management for patients with Carcinoid Syndrome?

The Serotonin (5-HT) secreted by the tumours can cause the following conditions:

  • Diarrhoea leading to dehydration, acidosis and hypokalaemia
  • Flushing attacks
  • Right heart endocardial fibrosis
  • Pulmonary Stenosis
  • Changes in blood pressure
  • Bronchospasm

 

Intraoperative hypotension in patients with carcinoid syndrome is usually related to hypovolemia. This can be treated with fluids.

Care should be taken when using vasopressors as they can exacerbate serotonin release.

In Carcinoid syndrome good preoperative control with octreotide is needed.