Chapter 19 - Anesthesia for carotid body tumor resction

Summary

The perioperative anesthetic management of carotid body tumor resection includes a comprehensive preoperative airway assessment, optimization of patient comorbidities, and identification of symptoms pointing to secreting tumors. The goals of intraoperative hemodynamic management are to maintain normal baseline hemodynamics, avoiding extreme swings in blood pressure and heart rate. Whether regional or general anesthesia is used, the goals of perioperative management are to preserve stable hemodynamics and maintain end-organ perfusion, to prepare for resuscitation of acute major blood loss, to utilize monitoring modalities to identify, avoid, and manage cerebral ischemia, and to provide a smooth controlled emergence. Internal carotid artery clamping, reconstruction or sacrifice may be required for large grade III tumors or when the internal carotid artery is inadvertently injured. In the postoperative period, complications should be anticipated, diagnosed, and promptly managed. Patients undergoing bilateral carotid tumor surgery should be continuously monitored in an intensive care environment postoperatively.