Perioperative management of a patient with cushing disease undergoing transsphenoidal resection of pituitary tumours

Pituitary tumours are frequently encountered and comprise of around 20% of primary brain tumours undergoing intracranial operations. Most of them are non-functional, adrenocorticotropic hormone secreting tumours causing Cushing disease are quite few. They are managed medically most of the time, very few require surgical intervention. The perioperative management of these patients is quite challenging due to multisystem involvement. We hereby describe the successful management of a 56-year-old female patient having body mass index = 42 kg/m² who had typical features of Cushing disease. Difficult airway was anticipated (MPG- III, short neck, large tongue). Diabetes and hypertension were other comorbities. Other perioperative concerns were positioning, intravenous cannulation, ventilation, haemodynamic stability, extubation and post-operative pain. Careful understanding of the neuroendocrine manifestations and judicious and meticulous planning leads to successful management of the patient.

No conflict of interest has been declared by the author(s).