Dr. Eugene Woltering’s Octreotide Protocol for Surgery

Dr. Woltering’s Octreotide Protocol:
The NOLA NETS group uses this–others use less–can’t speak to their results but even with these “higher than others” type dosing we have had 2 carcinoid crisis out of about 300 OR visits–

  • Two hours before surgery give 500 micrograms of octreotide acetate IV Push
  • Then start a 500 microgram per hour IV infusion —– start this immediately after the IV push and continue infusion during and after surgery
  • Depending on the severity and duration of surgery—– taper the infusion over 1-24 hours–say for colonoscopy taper over 1 hour– after huge liver cases taper over 12-24 hours
  • If patient crashes don’t use pressors (except as a last resort if the following fails)– use fluids and 1-5 mg bolus of octreotide (can repeat)– for malignant hyperthermia use dantrolene in normal doses
  • If all else fails print this out and hand it to your anesthesia person along with my cell phone number 504-884-3555-if the get into trouble have ’em call me day or night