Images in Anesthesiology: Carotid Sinus Reflex From Neck Mass and Opioids

Images in Anesthesiology: Carotid Sinus Reflex From Neck Mass and Opioids

Surgery on head and neck masses presents unique challenges to overcome, especially in relation to preoperative anesthesia induction. Tumor proximity to the carotid sinus can result in extreme hemodynamic depression, by way of compression or direct invasion of the node. Neck hyperextension required f...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) Vol. 16; no. 6; p. e62048
Main Authors: Vrionis, Andrea N, Olsen, Kevin R
Format: Journal Article
Language:English
Published: United States Cureus Inc 10-06-2024
Cureus
Subjects:
Anesthesiology
Antihypertensives
Beta blockers
Biopsy
Cardiac arrhythmia
Cardiovascular disease
Electrocardiography
Fentanyl
Head & neck cancer
Hemodynamics
Hypertension
Hypotension
Intubation
Ketamine
Laryngoscopy
Lymphoma
Medical personnel
Narcotics
Neck
Otolaryngology
Patients
Radiology
Surgery
Tomography
Tumors
United States > US
carotid sinus
otolaryngology
head and neck tumors
opioid
anesthesia
Online Access:Get full text
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Description
Summary:Surgery on head and neck masses presents unique challenges to overcome, especially in relation to preoperative anesthesia induction. Tumor proximity to the carotid sinus can result in extreme hemodynamic depression, by way of compression or direct invasion of the node. Neck hyperextension required for endotracheal intubation can worsen the underlying compression. Additionally, many anesthetic agents have sympatholytic properties that can exacerbate this imbalance further toward the parasympathetic response. We present a case of a patient with non-Hodgkin lymphoma whose tumor compression of the carotid sinus precipitated an exaggerated vagal reflex response following fentanyl administration.
Bibliography:ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
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ObjectType-Report-1
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ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.62048