[Anesthetic management of pheochromocytoma by continuous intravenous injection of prostaglandin E1].
We had five cases of surgical removal of pheochromocytoma by continuous intravenous injection of prostaglandin E1. During anesthesia, we used Swan-Ganz catheter for circulatory monitoring and measured plasma catecholamines. When PGE1 dose was increased from 0.05 to 0.1 and 0.15 microgram.kg-1.min-1, total systemic vascular resistance and mean arterial pressure were decreased but heart rate and cardiac output were not significantly altered from the preanesthetic values. Plasma catecholamines were also similar to the preanesthetic values. Therefore, the results suggest that the mechanism of suppression of hypertension by PGE1 is by affecting vascular beds directly rather than by diminishing catecholamine excretion from sympathetic nerve and adrenal medulla. During manipulation of pheochromocytoma, mean arterial blood pressure increased extremely. Although PGE1 was injected at a rate of 0.3 to 0.5 microgram.kg-1.min-1 in some cases, we could not suppress the elevation of blood pressure. PGE1 alone could not normalize blood pressure and heart rate, and other cardiovascular agents were necessary.
Denda
S
S
Department of Anesthesiology, School of Medicine, Niigata University.
Sakuma
K
K
Satomi
K
K
Fujiwara
N
N
Fukuda
S
S
Shimoji
K
K
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D000527:Alprostadil / Q000008:administration & dosage / Q000627:therapeutic use*; D000758:Anesthesia; D003131:Combined Modality Therapy; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010673:Pheochromocytoma / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*
D000527:Alprostadil