Anaesthetic management of phaeochromocytoma.
The incidence, mortality, physiology, clinical findings and diagnosis of phaeochromocytoma are reviewed. Treatment, after adequate medical stabilization, must be surgical because of the high incidence of malignancy. Alpha-adrenergic receptor blockade and beta-adrenergic receptor blockade in the preoperative period was discussed. Anaesthetic management of patients with phaeochromocytoma requires close monitoring. Virtually all inhalational anaesthetic agents have been used in cases of phaeochromocytoma. Recent reports have favored enflurane. The merits of neuroleptanaesthesia and the various muscle relaxants are also discussed. Most authors favour lidocaine over propranolol for management of dysrhythmias during operation. Phentolamine or sodium nitroprusside are used for hypertension during operation. Hypotension is treated by fluid replacement with nor-epinephrine if a vasopressor becomes necessary. Close monitoring is necessary in the postoperative period. Adequate urinary output is of more importance than actual blood pressure levels.
D000310:Adrenal Gland Neoplasms / Q000601:surgery; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001145:Arrhythmias, Cardiac / Q000188:drug therapy; D001794:Blood Pressure / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007430:Intraoperative Care; D008012:Lidocaine / Q000627:therapeutic use; D009458:Neuroleptanalgesia; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology; D010673:Pheochromocytoma / Q000601:surgery; D011182:Postoperative Care; D011229:Preanesthetic Medication; D011300:Preoperative Care; D011433:Propranolol / Q000627:therapeutic use
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D009466:Neuromuscular Blocking Agents; D008012:Lidocaine; D011433:Propranolol