[Phaeochromocytoma and pregnancy: anaesthetic management about two cases].
Phaeochromocytoma during pregnancy is an uncommon situation and there are only few reports on the anaesthetic management of these patients at the time of the caesarean section. These cases require a multidisciplinary collaboration. We reported two cases of parturient with late diagnosis of noradrenergic phaeochromocytoma. Caesarean section was made in both cases before the delayed surgical treatment of the phaeochromocytoma itself. We precisely described the hypertension management before caesarean section in both cases and the anaesthetic techniques used for the surgery: general anaesthesia in the first case and locoregional anaesthesia in the second one. General anaesthesia used to be the most described technique in the past years. However, some arguments seem to indicate that locoregional anaesthesia could be a better technique in terms of peroperative hypertension control and fetal morbidity. Moreover, magnesium sulfate should be considered as a first line treatment for the control of peroperative hypertension. Our second case is one more description of the use of locoregional anaesthesia in this particular situation, as it was previously poorly reported. Further studies are needed to definitely assess the superiority of locoregional anaesthesia in terms of morbi-mortality in this context.
Bierlaire
D
D
Service d'anesthésie-réanimation, CHT Mamao, BP 1640, 98713 Papeete, Polynésie française, France. bibikirt@gmail.com
Péa
D
D
Monnier
F
F
Delbreil
J-P
JP
Bessout
L
L
D000310:Adrenal Gland Neoplasms; D000328:Adult; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D005260:Female; D006801:Humans; D010673:Pheochromocytoma; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic