Anesthesia for Endocrine Emergencies

Anesthesiol Clin. 2020 Mar;38(1):149-163. doi: 10.1016/j.anclin.2019.10.006. Epub 2020 Jan 2.


Although endocrine emergencies are not common occurrences, their identification and careful perioperative management are of paramount importance for reduction of patient morbidity and mortality. The most common critical endocrine abnormalities are associated with functional tumors, such as pheochromocytomas, insulinomas, and carcinoid tumors, leading to carcinoid syndrome, abnormal thyroid function, or disturbances in the hypothalamus-pituitary-adrenal axis, causing adrenal insufficiency. This article aims to discuss the pathophysiology, diagnosis, and perioperative management of pheochromocytomas, hyperthyroidism, hypothyroidism, adrenal insufficiency, carcinoid disease, and insulinomas.

Keywords: Hyperthyroidism; Hypoglycemia; Hypothyroidism; Insulinoma; Myxedema coma; Paraganglioma; Pheochromocytoma; Thyrotoxicosis.

Publication types

  • Review

MeSH terms

  • Adrenal Gland Neoplasms / diagnosis
  • Adrenal Gland Neoplasms / surgery
  • Adrenal Insufficiency / surgery
  • Anesthesia / methods*
  • Emergencies
  • Endocrine System Diseases / surgery*
  • Humans
  • Hypothyroidism / surgery
  • Insulinoma / surgery
  • Malignant Carcinoid Syndrome / surgery
  • Perioperative Care
  • Pheochromocytoma / diagnosis
  • Pheochromocytoma / surgery
  • Thyrotoxicosis / diagnosis
  • Thyrotoxicosis / surgery