title: Urinary catecholamines and metabolites in the immediate postoperative period following major surgery.
abstract: BACKGROUND
  Induction of anaesthesia can precipitate catecholamine release from an undiscovered pheochromocytoma and induce a hypertensive crisis. However, it is assumed that catecholamine and metabolite values resulting from the effects of surgery per se in the early postoperative period would overlap with the values generated by a tumour, and it is not known how soon after biochemical investigations can be carried out.
  
  
  OBJECTIVE
  To study patterns of urinary catecholamine excretion and the feasibility of biochemical screening for phaeochromocytomas in the immediate postoperative period in otherwise healthy subjects undergoing a single type of major surgical procedure.
  
  
  METHODS
  Catecholamines and metabolites were measured for each mole of creatinine in single voided urine on one preoperative and four postoperative days in five subjects who underwent elective coronary artery bypass graft surgery with an uncomplicated postoperative course. Reference ranges were established from 33 healthy normotensive volunteers.
  
  
  RESULTS
  Excretion of adrenaline, noradrenaline, dopamine, vanillylmandelic acid, and metadrenaline was within normal limits. Normetadrenaline excretion was mildly raised in four patients, but did not exceed 1.5 times the upper reference limit, and returned to normality by the fourth postoperative day.
  
  
  CONCLUSIONS
  It is feasible to perform simple urinary screening for possible phaeochromocytoma in the immediate postoperative period.
authors.affiliation: Department of Medical Biochemistry, University Hospital of Wales, Cardiff CF14 4XW, UK. a.a.syed@ncl.ac.uk
authors.forename: A A
authors.initials: AA
authors.lastname: Syed
authors.forename: H A
authors.initials: HA
authors.lastname: Wheatley
authors.forename: M N
authors.initials: MN
authors.lastname: Badminton
authors.forename: I F W
authors.initials: IF
authors.lastname: McDowell
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000652:urine; D002395:Catecholamines / Q000652:urine*; D001026:Coronary Artery Bypass; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000175:diagnosis*; D011184:Postoperative Period; D012016:Reference Values
chemical_list: D015415:Biomarkers; D002395:Catecholamines