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Anaesthesia and concurrent disease 

Anaesthesia and concurrent disease

Philip M. Hopkins

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date: 30 November 2020

Anaesthesia for patients with endocrine disorders involves the management of both extremely common and extremely rare conditions. There is a high incidence of diabetes, hypothyroidism, and hyperthyroidism in the population but pituitary apoplexy, phaeochromocytoma, and insulinoma may never be encountered during the career of the general anaesthetist. Whenever possible, elective surgery should await normalization of abnormal endocrine function. For example, patients with uncontrolled hyperthyroidism are at risk of developing a thyroid crisis so elective surgery should be delayed until they are euthyroid. This chapter discusses the anatomy, physiology, and anaesthetic management for surgery on the pituitary, thyroid, parathyroid, and adrenal glands. Anaesthetic issues relating to patients with diabetes mellitus and carcinoid tumours are covered in detail. Endocrine emergencies may mimic other causes of cardiovascular collapse and successful management requires a multidisciplinary approach involving anaesthetists, endocrinologists, surgeons, accident and emergency, and intensive care specialists.

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