Korean J Anesthesiol.  1991 Feb;24(1):206-210. 10.4097/kjae.1991.24.1.206.

Anesthetic Management of a Patient with Pheochromocytoma

• Lee HW
• Kim JU
• Lim HJ
• Chae BK
• Chang SH
• Shin JS

• KMID: 2239393
• DOI: http://doi.org/10.4097/kjae.1991.24.1.206

Abstract

Pheochromocytoma is functioning tumor which originates in the adrenal medulla or in chromaffin tissue along the paravertebral sympathetic chain. This tumor releases epinephrine and norepinephrine causing increase of peripheral resistance and resulting in increased blood pressure and reducing plasma volume. The anesthetic management of patients with pheochromocytoma presents many difficult problems such as hypertension, cardiac arrhythmias, and hypotension. A 40 year-old female underwent resection of pheochromocytoma under general anesthesia. Thiopental was used for induction followed N2O-O2-enflurane supplemented with fractional doses of fentanyl and vecuronium for muscle relaxation. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside, and premature ventricular beats were controlled with lidocaine. We experienced marked fluctuation of blood pressure during anesthetic course.

Keyword

Pheochromocytoma

MeSH Terms

Adrenal Medulla
Adult
Anesthesia
Anesthesia, General
Arrhythmias, Cardiac
Blood Pressure
Epinephrine
Female
Fentanyl
Humans
Hypertension
Hypotension
Lidocaine
Muscle Relaxation
Nitroprusside
Norepinephrine
Phentolamine
Pheochromocytoma*
Plasma Volume
Thiopental
Vascular Resistance
Vecuronium Bromide
Ventricular Premature Complexes
Epinephrine
Fentanyl
Lidocaine
Nitroprusside
Norepinephrine
Phentolamine
Thiopental
Vecuronium Bromide