ABSTRACT
How anesthetic management of patients with carcinoid tumors has evolved over recent decades is well summarized in several good reviews (1-3). The early concept of a relatively benign gastrointestinal (GI) tumor producing a single hormone (serotonin) has changed into a complex picture, in which we know that numerous mediators are involved and surgery is becoming increasingly extensive. The perioperative course, on the other hand, has become considerably less dramatic since somatostatin analogues were introduced to the therapeutic arsenal. One study (4) summarizes the perianesthetic risks and outcomes of 119 patients that underwent surgery in 1983 to 1996 at a tertiary center. It was shown that the intraoperative use of octreotide (Food and Drug Administration approval in 1988) reduced the incidence of complications during surgery. The two main risk factors for complications were found to be carcinoid heart disease and high preoperative urinary serotonin metabolite 5-Hydroxyindolacetic acid (5-HIAA) output. It should be noted, however, that the overall incidence of perioperative complications or death was low (12%).
