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Is this a manifestation of carcinoid syndrome? Carcinoid tumours are often found incidentally during surgery for appendicitis. Stoelting's anesthesia and co-existing disease. p289 refl.in/8j

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Salbutamol can be administered in circuit by removing the cannister from an inhaler, placing it inside a 50ml syringe barrel, and connecting it to a pediatric elbow join. Press the plunger at the beginning of inspiratory phase.

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Salbutamol can quickly be administered via the ETT by connecting the mouthpiece of the inhaler to the end of the ETT

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Risk assessment for respiratory complications in paediatric anaesthesia: a prospective cohort study.

dx.doi.org/10.1016/S0140-...

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Consider disconnecting the ETT and delivering salbutamol via a metered dose inhaler (MDI). This does two things:
1. The act of disconnection provides a prolonged expiration reducing any gas trapping. (Gas trapping may decrease cardiac output, mimicking hypotension seen in anaphylaxis)
2. bronchodilates

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