Carcinoid Crisis Octreotide — FRCA Final MCQ

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HardGeneral AnaesthesiaCarcinoid Crisis OctreotideFRCA Final

A 55-year-old man (ASA III) with carcinoid syndrome is listed for excision of a hepatic metastasis. During tumour manipulation he develops severe bronchospasm, flushing, and hypotension. Which drug is specifically indicated for a carcinoid crisis?

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Correct answer: D — Octreotide

Carcinoid crisis is a life-threatening complication caused by massive release of serotonin and other vasoactive substances during tumour manipulation. Octreotide (somatostatin analogue) 50-100 mcg IV bolus followed by an infusion (50 mcg/hr) is the specific treatment – it inhibits the release of vasoactive mediators from carcinoid tumour cells. Standard treatments for bronchospasm (beta-agonists, aminophylline) and hypotension (adrenaline) may be ineffective or paradoxically worsen symptoms. Prophylactic octreotide infusion should be started pre-operatively.

Reference: RCOA – 2023 – Endocrine anaesthesia module; UKI-NETS – 2021 – Carcinoid syndrome guidelines