Complications of Carcinoid Tumors

Case Synopsis

A 55-year-old man is scheduled for emergency exploratory laparotomy for small bowel obstruction. Anesthesia is induced with intravenous (IV) fentanyl, lidocaine, propofol, and succinylcholine and maintained with sevoflurane in an air-oxygen mixture with vecuronium. During the surgery the patient becomes profoundly hypotensive. His blood pressure does not respond to boluses of IV fluid, ephedrine, and epinephrine. The patient’s face and neck appear flushed.