[Anaesthesia for patients with phaeochromocytoma - specifics, potential complications and drug strategies].
Perioperative management of patients with phaeochromocytoma requires detailed knowledge on the pathophysiology and potential complications. Intraoperatively, hypertensive crisis and tachyarrhythmias may occur resulting from massive catecholamine release. Thus, preoperative treatment with the alpha-antagonist phenoxybenzamine is obligatory. In contrast, sodium nitroprusside is the substance of choice for intraoperative control of blood pressure. alpha-blocking agents may be used in phaeochromocytoma but only under sufficient alpha-blockade. Removal of a malignant tumour of the adrenal gland may induce massive haemorrhage, and thus anaesthetic management has to be modified.
Knüttgen
Dirk
D
Klinik für Anästhesio logie und operative Intensivmedizin des Krankenhauses Köln-Merheim. knuettgend@klinikenkoeln.de
Wappler
Frank
F
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000758:Anesthesia / Q000379:methods*; D000959:Antihypertensive Agents / Q000008:administration & dosage; D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000209:etiology / Q000517:prevention & control*; D009599:Nitroprusside / Q000008:administration & dosage*; D010643:Phenoxybenzamine / Q000008:administration & dosage*; D010673:Pheochromocytoma / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*
D000959:Antihypertensive Agents; D010643:Phenoxybenzamine; D009599:Nitroprusside