Spinal and Intracranial Surgery
For patients undergoing elective spinal surgery and brain surgery some blood tests will be required in order to make sure that it is safe for us to go ahead with a general anaesthetic and surgery
These will usually comprise:
- Full blood count, this checks for anaemia and signs of infection
- Urea and electrolytes, checks the function of the kidneys, and the salt / water balance in the blood
- Blood clotting screen, checks how effectively the blood clots
- Type and crossmatch, allows us to categorise your blood group and if required arrange for some bags of blood to be available should you need them during surgery
Before Surgery For Pituitary Tumours
The blood tests prior to pituitary surgery are a little more involved. This is because the hormone levels will need to be measured, and some of these hormones are produced in differing quantities at different times of the day, and depends on the age, sex, and pre or post menopausal status.
For most pituitary patients a pituitary assessment will be performed as part of being seen in our joint pituitary clinic. This will involve a test called a short synacthen test which comprises an injection and a series of blood tests over a few hours. It may seem strange to go through such involved blood tests, but if surgery is being considered it is very important to establish whether your body can respond to stressful events. If you are missing important hormones, not only will you feel unwell, but illness or surgery can become potentially more dangerous.
The endocrine team at the Oxford Centre for Diabetes Endocrinology and Metabolism (OCDEM) will liaise with you and your GP a few days after these tests to relay any important information, especially if we have advised starting some new medication.
The contact number for the specialist endocrine nursing team on Bagot and Drake ward in OCDEM is 01865 857338
Specialist Pituitary Investigations
Where further investigations are required in cases of acromegaly or Cushing’s disease we need to measure the hormones in more detail.
In acromegaly this will involve a test of how the growth hormone (GH) levels respond to a sugary drink over a few hours, and often how the GH levels respond to an injection of a drug to suppress GH called a somatostatin analogue.
In Cushing’s Disease we perform a variety of tests as firmly establishing the diagnosis of Cushing’s Disease can difficult. This usually involves a fasting a.m. cortisol level, looking at how the cortisol levels suppress with dexamethasone, cortisol levels at midnight, and a stimulation test. Sometimes directly measuring the ACTH levels being produced by the pituitary is required, this is called inferior petrosal suns venous sampling. Some of these tests require a stay in hospital for 2-3 days.