Development of Effective Prophylaxis against Intraoperative Carcinoid Crisis

Woltering EA1, Wright AE2, Stevens MA3, Wang YZ4, Boudreaux JP5, Mamikunian G6, Riopelle JM7, Kaye AD8

J Clin Anesth. 2016 Aug; 32: 189-93

STUDY OBJECTIVE:

The prophylactic use of a preoperative, intraoperative, and postoperative high-dose continuous octreotide acetate infusion was evaluated for its ability to minimize the incidence of carcinoid crises during neuroendocrine tumor (NET) cytoreductive surgeries.

MAIN RESULTS:

One hundred sixty-nine (169/179; 94%) patients had normal anesthesia courses. The medical records of 10 patients were further investigated for a potential intraoperative crisis using the aforementioned criteria. Upon review, 6 patients were determined to have had a crisis. The final incidence of intraoperative crisis was 3.4% (6/179).

CONCLUSIONS:

A continuous high-dose infusion of octreotide acetate intraoperatively minimizes the incidence of carcinoid crisis. We believe that the low cost and excellent safety profile of octreotide warrant the use of this therapy during extensive surgical procedures for midgut and foregut NETs.

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