[Anesthesiological management of a patient with primary aldosteronism complicated with hypertrophic cardiomyopathy].
A 49-year-old male with primary aldosteronism, accompanied by hypertrophic cardiomyopathy (HCM), underwent our anesthesiological management for resection of a left adrenal tumor. The preoperative examination revealed hypertension, mild nephropathy and hypokalemia. Spilnolactone treatment was discontinued 3 days before surgery. In the operating room, a Swan-Ganz catheter was inserted for monitoring hemodynamic parameters. Anesthesia was maintained with nitrous oxide-oxygen-isoflurane and vecuronium. During the surgery, prostaglandin E1 and nitroglycerin were used as vasodilators. During surgery, the patient was successfully managed, anesthesiologically. In anesthesiological management of patients with primary aldosteronism, care is needed regarding changes in blood pressure and electolyte levels during adrenalectomy. In cases where aldosteronism is accompanied by HCM, as in the present case, hemodynamic changes can cause a fatal outcome, and hence, carefulness is needed in using anesthetics and drugs which act on the circulatory system.
Matsuda
M
M
Department of Anesthesiology, Hyogo College of Medicine, Nishinomiya.
Okutani
R
R
Kono
K
K
Fukuda
T
T
Ochiai
N
N
Kishimoto
A
A
D000315:Adrenalectomy; D000758:Anesthesia / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications*; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged