Korean J Anesthesiol.  2007 Sep;53(3):411-415. 10.4097/kjae.2007.53.3.411.

Acute Pulmonary Edema for Surgical Removal of Pheochromocytoma: A case report

• Kim CK
• Han SJ
• Lee JH
• Kwon YE

• KMID: 2039639
• DOI: http://doi.org/10.4097/kjae.2007.53.3.411

Abstract

This report describes the perioperative management of an adrenergic crisis and intraoperative pulmonary edema occurring during planned surgery for pheochromocytoma. We experienced the anesthetic management of a 45-year-old male patient with pheochromocytoma on the extra-adrenal retroperitoneum. The patient had been treated with prazosin for only 1 week before surgery. After inducing anesthesia with intravenous remifentanil, thiopental sodium, and rocuronium, anesthesia was maintained with nitrous oxide, oxygen, and isoflurane administration. The blood pressure was poorly controlled with sodium nitroprusside, esmolol, and remifentanil after manipulating the tumor. Pulmonary edema occurred intraoperatively but subsided with positive end expiratory pressure and the use of diuretics and morphine. After removing the tumor, the blood pressure was well controlled using a colloid solution, Hartman's solution, and dopamine administration. This complication occurred because of inadequate preoperative preparation. We reported this case of surgery for the removal of a pheochromocytoma with a review of the relevant literature.

Keyword

pheochromocytoma; prazosin; pulmonary edema

MeSH Terms

Anesthesia
Blood Pressure
Colloids
Diuretics
Dopamine
Humans
Isoflurane
Male
Middle Aged
Morphine
Nitroprusside
Nitrous Oxide
Oxygen
Pheochromocytoma*
Positive-Pressure Respiration
Prazosin
Pulmonary Edema*
Thiopental
Colloids
Diuretics
Dopamine
Isoflurane
Morphine
Nitroprusside
Nitrous Oxide
Oxygen
Prazosin
Thiopental