Anaesthesia for phaeochromocytoma in pregnancy.
OBJECTIVE
Phaeochromocytoma in pregnancy is a rare occurrence. Details of the anaesthetic are even more rarely reported. Our purpose is to describe our management with reference to previous reports.


METHODS
A 31-yr-old woman underwent resection of a phaeochromocytoma at seven weeks gestation. Preoperative preparation included 2 mg prazosin p.o. bid and 40 mg propranolol p.o. bid. A balanced anaesthetic technique including 5 mg midazolam, 1500 micrograms alfentanil, 35 micrograms sufentanil, nitrous oxide and isoflurane was used. Blood pressure was controlled with 3.4 g magnesium and 2437 micrograms nitroglycerin. There were no episodes of hypertension intraoperatively. The patient made an uneventful recovery and delivered a normal baby at 37 wk gestation by caesarean section.


CONCLUSIONS
Anaesthesia for resection of a phaeochromocytoma in early pregnancy can be successfully managed with preoperative alpha and beta sympathetic blockade and a balanced anaesthetic technique using magnesium as the main intraoperative hypotensive agent.
Hamilton
A
A
University of British Columbia Department of Anaesthesia, St Pauls' Hospital, Vancouver, Canada.
Sirrs
S
S
Schmidt
N
N
Onrot
J
J
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000328:Adult; D000758:Anesthesia / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010673:Pheochromocytoma / Q000601:surgery*; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000601:surgery*