Anesthetic management of a case of insulinoma

Insulinomas are an uncommon cause for recurrent hypoglycemia. Surgical resection is the definitive treatment. We present a case of an 87 year old female patient diagnosed with insulinoma who had history of recurrent hypoglycemic attacks and neurological deficits due to seizure induced hypoxic episodes. Laparoscopic enucleation of the tumor was undertaken. Perioperative management of blood sugar in these patients is of utmost importance. As anesthesiologists our target is to prevent severe hypoglycemic episodes which may lead to permanent neurological damage and severe hyperglycemia post procedure which has to be managed by titrating the dose of insulin and dextrose

Anesthesia for dermatological surgery.

Knowledge of local anesthesia is critically important to perform dermatological surgery. Local anesthetics when used judiciously are extremely safe and allow dermatologists to perform a variety of procedures. This article aims to provide an updated review of local anesthesia and local anesthetic drugs. Side effects of local anesthetics and techniques of regional anesthesia are discussed and some commonly used nerve blocks are explained. A detailed knowledge of the pharmacology of local anesthetics aids in optimal therapeutic use, and in prevention, early diagnosis and management of their toxicities by the clinician.