PERIOPERATIVE ANESTHETIC MANAGEMENT OF A PATIENT UNDERGOING CAROTID BODY TUMOR REMOVAL: FOCUS ON HEMODYNAMICS

Abstract

Background: Carotid body tumors (paragangliomas) are uncommon neuroectodermal neoplasms, constituting roughly 1–2% of all head and neck cancers. Their proximity to the carotid vessels and cranial nerves presents considerable perioperative anesthetic problems, especially regarding the danger of hemodynamic instability during tumor manipulation.
Case presentation: We detail the perioperative anesthetic care of a 68-year-old female with a left-sided carotid body tumor, who experienced flushes, palpitations, and headaches. Preoperative imaging confirmed the diagnosis, while the preoperative assessment identified a potentially difficult airway and the need for invasive monitoring. General anesthesia was administered with invasive arterial and central venous monitoring. During tumor dissection, the patient experienced recurring bouts of vagally mediated bradycardia, which resolved upon cessation of manipulation and the administration of atropine and low-dose adrenaline infusion. Hemodynamic stability and sufficient cerebral perfusion were preserved during the surgery. The postoperative recovery was unremarkable, and the patient was discharged on the third day after surgery.
In conclusion: Meticulous hemodynamic monitoring, prompt intervention for vagal reactions, and thorough multidisciplinary collaboration are crucial for the safe administration of anesthesia during carotid body tumor removal.