[Perioperative therapy in juvenile pheochromocytoma].
The article reports on the paediatric-anaesthesiological treatment of 6 phaeochromocytomas in 5 children who were 8 to 16 years of age. Therapeutic recommendations for the perioperative medication of infantile phaeochromocytoma patients are involved. The therapeutic aim of this study was the management of the effects of phaeochromocytoma before and after extirpation of the tumour, the effect of the phaeochromocytoma being of an alpha-adrenergic and beta-adrenergic cardiovascular nature and transmitted by catecholamines. Preoperative stabilization of blood pressure by means of the alpha-blocker phenoxybenzamine and a subsequent intraoperative, controlled reduction of blood pressure by means of sodium nitroprusside were found to be an effective, safe and easily appreciated therapeutic concept for the perioperative care of paediatric phaeochromocytoma patients. Considerable individual differences in dose an duration of the necessary preoperative phenoxybenzamine administration rendered ward control of therapy recommendable. The risk of complete alpha-sympathicolysis by additive drug effects during premedication and induction of anaesthesia, had to be taken into consideration for conducting phenoxybenzamine therapy. Additional administration of the beta-blocker pindolol successfully controlled the intraoperatively manifested tachycardial heart rhythm phases without provoking any complicating arrhythmias. During the entire perioperative treatment of the patients it is mandatory to ensure sufficient substitution of intravascular volume to prevent hypotensive complications. Our patients did not need any cardiac and sympathicomimetic drugs as postoperative administration. None of the patients had any perioperative complications worth mentioning.
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000768:Anesthesia, General / Q000379:methods; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D007430:Intraoperative Care; D008297:Male; D009599:Nitroprusside / Q000008:administration & dosage; D010643:Phenoxybenzamine / Q000008:administration & dosage; D010673:Pheochromocytoma / Q000601:surgery*; D010869:Pindolol / Q000008:administration & dosage; D011292:Premedication; D013610:Tachycardia / Q000517:prevention & control
D010643:Phenoxybenzamine; D009599:Nitroprusside; D010869:Pindolol
Die perioperative Therapie beim kindlichen Phäochromozytom.