ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

ENDOCRINOLOGIC ANESTHESIA

Kahir Güneş

Polatlı Duatepe State Hospital, Department of Anesthesiology and Reanimation, Ankara, Türkiye

Güneş K. Endocrinologic Anesthesia. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.341-354.

ABSTRACT

  • The endocrine system serves a pivotal role in the maintenance of physiological homeostasis through the intricate regulation of hormonal pathways. Endocrine disorders are encountered in the perioperative management of surgical patients both as primary surgical reasons and as comorbidities influencing perioperative outcomes. This section focuses on the pancreas, thyroid, parathyroid, and adrenal glands, addressing perioperative hemodynamic, hormonal, and treatment process management strategies in disorders related to these organs.
  • Patients with diabetes, thyroid diseases, and hypothalamic-pituitary-adrenal axis suppression are frequently encountered in the surgical setting. A patient-centered evaluation is required to optimize perioperative risk in these individuals. The perioperative management of endocrine disorders necessitates a multidisciplinary approach. The primary aim of preoperative assessment is to determine the severity of endocrine disorders before surgery, enabling the surgical team, anesthesiologists, and internal medicine specialists to plan management accordingly.
  • Diabetes mellitus is a growing global health concern and a significant cause of morbidity and mortality. Comprehensive preoperative evaluation involves optimizing glycemic status, identifying target organ damage, and adjusting antidiabetic therapies. Effective perioperative glycemic control reduces the risk of postoperative wound infections and perioperative cardiovascular events, as well as prevents prolonged hospital stays.
  • Thyroid dysfunctions, such as hyperthyroidism and hypothyroidism, require careful management to avoid complications like perioperative thyrotoxic crisis or myxedema coma. Surgical interventions for thyroid pathologies necessitate airway assessment and postoperative monitoring for complications such as recurrent laryngeal nerve injury. In cases of parathyroid disorders, such as hyperparathyroidism and hypoparathyroidism, managing electrolyte levels and determining treatment needs are essential.
  • Pheochromocytoma, hypercortisolism, and aldosterone imbalances, which are included in adrenal disorders, require close cardiovascular hemodynamic monitoring, electrolyte level control, and medical preparation. Detailed symptom evaluation is essential in critical conditions such as adrenal insufficiency, Cushing’s syndrome, and hypertensive crises to plan treatment protocols.
  • Glycemic control, hemodynamic stability, airway management, and correction of electrolyte imbalances minimize complications and improve outcomes. This section provides a comprehensive guide for surgical planning and anesthesia management in endocrine disorders.

Keywords: Anesthesia; Endocrinology; Perioperative period; Pancreas; Thyroid gland; Parathyroid gland; Adrenal glands.

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