Anesthetic Management of Carotid Body Tumor Excision: Experience and Preoperative Predictors of Outcomes in a Multi-institutional Retrospective Analysis.

OBJECTIVES

Carotid body tumor (CBT) excision is a rarely performed operation with numerous anesthetic challenges. Little evidence exists to guide best practice. Our objective was to characterize contemporary anesthetic care and identify preoperative predictors for intraoperative hemodynamic instability, blood loss, surgical duration, and hospital length of stay for CBT excision.

DESIGN

Retrospective study spanning 21 years.

SETTING

Three tertiary academic hospitals.

PARTICIPANTS

Thirty-three patients who underwent CBT excision during study period.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN

RESULTS

Preoperative diagnosis of essential hypertension was correlated with intraoperative hypotension requiring therapy. Preoperative hypertension on the day of surgery did not correlate with intraoperative hemodynamics. Surgical duration increased with male biologic sex, tumor greatest dimension, and tumor volume. Blood loss was significantly positively correlated with body mass index, tumor greatest dimension, and tumor volume. Hospital length of stay was increased with tumor greatest dimension and tumor volume.

CONCLUSION

This study identified preoperative variables that predict perioperative outcome metrics for CBT excision. The description of cases provided here establishes typical anesthetic techniques and values for a host of perioperative variables that may assist in anesthetic planning. With thoughtful interpretation to account for sample size and retrospective methodology, the results of this study serve as a tool for informing the anesthetic management of CBT excision.