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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| Published in: | Curēus (Palo Alto, CA) Vol. 16; no. 6; p. e62048 |
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| Main Authors: | , |
| Format: | Journal Article |
| Language: | English |
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United States
Cureus Inc
10-06-2024
Cureus |
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| Online Access: | Get full text |
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| Abstract | 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. |
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| AbstractList | 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. 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. 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.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. |
| Author | Olsen, Kevin R Vrionis, Andrea N |
| AuthorAffiliation | 2 Department of Anesthesiology, Moffitt Cancer Center, Tampa, USA 1 Morsani College of Medicine, University of South Florida, Tampa, USA |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38989339$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | Copyright © 2024, Vrionis et al. Copyright © 2024, Vrionis et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. Copyright © 2024, Vrionis et al. 2024 Vrionis et al. |
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| DOI | 10.7759/cureus.62048 |
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| Keywords | carotid sinus otolaryngology head and neck tumors opioid anesthesia |
| Language | English |
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| Snippet | Surgery on head and neck masses presents unique challenges to overcome, especially in relation to preoperative anesthesia induction. Tumor proximity to the... |
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| SubjectTerms | 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 |
| Title | Images in Anesthesiology: Carotid Sinus Reflex From Neck Mass and Opioids |
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