[Severe hypotension after removal of pheochromocytoma in a pediatric patient].
An 8-year-old male patient with pheochromocytoma pretreated with prazocin, carteolol, and enarapril received sevoflurane general anesthesia with fentanyl. After removal of the tumor, blood pressure and urine volume decreased and ST segment in ECG was depressed. We administered dopamine and norepinephrine to increase blood pressure, but pulmonary edema became aggravated postoperatively. He was treated with noninvasive pressure support ventilation with face mask for 4 hours which was effective. His postoperative recovery was uneventful thereafter. We hypothesized that his hemodynamic deterioration was caused by sudden decrease in serum level of norepinephrine after the tumor removal, and the responsiveness to catecholamines was depressed by long exposure to norepinephrine. We conclude that we should use norepinephrine for anesthetic care even in pediatric patients as in adults.
Kurita
Shigeaki
S
Department of Anesthesiology and Critical Care, Hiroshima University Faculty of Medicine, Hiroshima 734-8551.
Tanaka
Hiroyuki
H
Sanuki
Michiyoshi
M
Kawamoto
Masashi
M
Yuge
Osafumi
O
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000768:Anesthesia, General; D002648:Child; D004837:Epinephrine / Q000097:blood; D006801:Humans; D007022:Hypotension / Q000209:etiology*; D008297:Male; D010673:Pheochromocytoma / Q000601:surgery*; D011183:Postoperative Complications
D004837:Epinephrine