Prevalence and risk factors of hemodynamic instability during endoscopic transsphenoidal pituitary surgery: a retrospective analysis

Authors : Fahri ACAR, Oya KILCI, Gülçin Hilal ÖZTÜRK ALAY, Canan ÜN, Hidayet ÜNAL, Derya GOKCİNAR

Pages : 153-157

Doi:10.32322/jhsm.679406

View : 32 | Download : 9

Publication Date : 2020-03-19

Article Type : Research Paper

Abstract :Objective: Intraoperative hemodynamic instability in patients undergoing endoscopic transsphenoidal pituitary surgery insert ignore into journalissuearticles values(ETSS); for pituitary adenoma may lead to significant complications. We aimed to investigate the prevalence of hemodynamic instability and its associated risk factors in these patients. Methods: This retrospective study included patients who underwent ETSS at Ankara Numune Training and Research Hospital between 14 January 2010 and 20 March 2014. Intraoperatively occurring episodes of bradycardia, hypotension, and hypertension were recorded. Distribution of hemodynamic instability was determined based on age groups, ASA class, tumor type, and anesthesia method. Results: A total of 323 patients met the study criteria. Mean age of the patients was 46.88 ± 13.91 years and 54.5% were female. Intraoperative bradycardia was detected in 137 patients insert ignore into journalissuearticles values(42.41%);, hypotension in 57 patients insert ignore into journalissuearticles values(17.65%);, and hypertension in five patients insert ignore into journalissuearticles values(1.55%);. Hemodynamic instability occurred in all of the patients over the age of 51. Patients classified as ASA III were more likely to have hemodynamic instability than patients with ASA I and ASA II insert ignore into journalissuearticles values(p<0.05);. All 18 patients who were transferred to intensive care unit were in the age group of 61 years and over. The rate of hemodynamic instability was higher in patients with non-functioning tumor compared to that in patients with functioning tumors. Conclusion: The rate of intraoperative hemodynamic instability in patients undergoing ETSS is higher in older patients than that in young patients. The elderly has multiple comorbidities and are more sensitive to anesthetic agents. This group needs a carefully planned anesthetic management during perioperative period.
Keywords : Pituitary adenoma, Endoscopic transsphenoidal pituitary surgery ETSS, Anesthesia Management