Anaesthetic management for Transnasal Endoscopic excision of Pituitary adenoma.

Out of all brain tumors,10% are pituitary tumors.Most commonly performed procedure is transsphenoidal pituitary surgery which requires skillful anaesthetic technique as a number of associated comorbidities may exist. Pitutary tumors may be associated with endocrine abnormalities reflecting on various aspects of anaesthetic management of airway abnormalities,fluid & electrolyte imbalance and fluctuating blood sugar levels.

A Emphasis is required on pre operative evaluation of airway, endocrinal & neurological status. A 16 yrs old male patient having pituitary macroadenoma,a k/c/o diabetes mellitus & hypothyroidism since 6 years & who is on medical treatment. He had complain of decreased vision in both eyes & numbness in both UL, LL associate with acute increase in blood sugar. His RBS was very fluctuating with early morning low blood sugar level. His hormonal profile : T3-0.5, T4-5.9, TSH- 42.28, Cortisol- 985.6. 2D Echo was normal, ECG- T wave inversion in lead V2-V6,lead-2,3,aVF. After correction of TSH(=6.693),transnasal endoscopic excision of tumor was performed under GA & patient was maintained hemodynamically stableintraoperatively without any complication under proper anaesthetic management

Conclusion :Anaesthetic management for pituitary surgery requires thorough preanesthetic assessment of hormonal function and intraoperative management to facilitate surgical exposure while providing hemodynamic stability and allowing for rapid emergence.