Anesthesia Considerations 

Hyperaldosteronism

 

 

 

 

Considerations

 

• Hypertension & end-organ dysfunction:

  • Cardiomyopathy 

  • Cerebrovascular disease

  • Chronic kidney disease 

• Fluid & electrolyte abnormalities:

  • Hypokalemia (weakness, potentiates non-depolarizing muscle relaxants)

  • Metabolic alkalosis

  • Volume depletion

  • Hypomagnesemia

• Associated endocrine disorders:

  • Acromegaly

  • Pheochromocytoma

  • Primary hyperparathyroidism

  • Medications such as spironolactone 

• Adrenalectomy:

  • Bilateral? Need steroids

  • Laparascopic vs. open (pain & disposition)

 

Optimization

 

• Antihypertensive therapy

• Correction of electrolyte abnormalities