Postoperative management of patients with pheochromocytoma.
The optimal preoperative and postoperative management of patients with pheochromocytoma demands a multidisciplinary approach. We report on 5 recent patients to illustrate the large volumes of fluid needed in the early postoperative period. This large fluid requirement is owing to a combination of a change in vascular compliance after excision of a pheochromocytoma, the residual effects of specific preoperative medications (phenoxybenzamine and alpha-methyl-p-tyrosine) and the loss of fluid into the retroperitoneal compartment (third space) produced by extensive dissection. It takes 3 half-lives (36 hours) to dissipate the effects of phenoxybenzamine and alpha-methyl-p-tyrosine, which corresponds to the time in which these patients require large volumes of intravenous fluids.
D000310:Adrenal Gland Neoplasms / Q000601:surgery / Q000628:therapy; D000328:Adult; D001803:Blood Transfusion; D001810:Blood Volume; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007680:Kidney Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000601:surgery / Q000628:therapy*; D011182:Postoperative Care