44-year-old man presents for transsphenoidal hypophysectomy with marked features of acromegaly. The patient reports increasing shoe size, glove size, and worsen-ing sleep apnea. Magnetic resonance imaging (MRI) revealed a pituitary mass. Laboratory findings are within normal limits with the exception of serum glucose of 170 mg/dL. The patient denies any allergies or medica-tions. Past surgical history includes carpal tunnel release bilaterally. He denies other medical problems.