Magnesium in the management of catecholamine-secreting glomus tumours with intracranial extension.
OBJECTIVE
Catecholamine-secreting glomus jugulare tumours are uncommon and their anesthetic management can be challenging. The authors present the first description of the use of magnesium sulfate in the management of two patients with catecholamine-secreting glomus jugulare tumours where there was significant intracranial extension.


METHODS
Patient 1 underwent a transmastoid transoccipital excision of a catecholamine-secreting glomus tumour. He exhibited marked hemodynamic instability after handling of the tumour began, which was not controlled by sodium nitroprusside. Improved hemodynamic stability was seen after the patient received magnesium sulfate. Patient 2 also underwent a transmastoid transoccipital excision of a catecholamine-secreting glomus tumour. Magnesium sulfate was commenced prior to tumour handling and continued until the tumour was removed. The patient remained hemodynamically stable. Sodium nitroprusside was not required.


CONCLUSIONS
Magnesium sulfate may be useful in preventing or minimizing the blood pressure changes associated with handling during excision of catecholamine-secreting glomus jugulare tumours. It may be of particular benefit in patients where there is significant intracranial extension.
Goutcher
Colin M
CM
Department of Neuroanaesthesia, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF, United Kingdom. c.goutcher@ntlworld.com
Cossar
Dora F
DF
Ratnasabapathy
Urmila
U
Burke
Anne M
AM
D000368:Aged; D000758:Anesthesia / Q000379:methods; D001794:Blood Pressure / Q000187:drug effects; D001932:Brain Neoplasms / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D002395:Catecholamines / Q000097:blood / Q000378:metabolism* / Q000652:urine; D005925:Glomus Jugulare Tumor / Q000150:complications / Q000378:metabolism* / Q000601:surgery; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology; D007431:Intraoperative Complications / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D008278:Magnesium Sulfate / Q000627:therapeutic use*; D008297:Male; D008416:Mastoid / Q000601:surgery; D008875:Middle Aged; D013997:Time Factors
D002395:Catecholamines; D008278:Magnesium Sulfate