[The perioperative management for pheochromocytoma resection in a patient with chronic renal failure requiring long-term hemodialysis].
We report the perioperative management of a 55-year-old man with chronic renal failure requiring long-term hemodialysis, who underwent laparoscopic adrenalectomy for pheochromocytoma. He was pretreated with doxazosin, a calcium channel blocker and a beta-adrenoceptor antagonist to control blood pressure until surgery. His dry weight increased slowly from 57 kg to 58.5 kg for a month increasing the intravascular volume. Neither did the patient develop pulmonary edema nor congestive heart failure preoperatively. Tumor resection was successfully completed under general anesthesia. Although noraderenaline was required to keep adequate blood pressure during surgery and the first day of intensive care unit stay, there was no adverse event during perioperative period. The increasing intravascular volume before pheochromocytoma surgery in a patient on hemodialysis might make the perioperative management safer, although further study is required to determine the adequate level of increment in the preoperative dry weight.
Yamane
Kochi
K
Department of Anesthesiology and Resuscitology, Okayama University Hospital, Okayama 700-8558.
Toda
Yuichiro
Y
Egi
Moritoki
M
Sato
Tetsufumi
T
Goto
Keiji
K
Katayama
Hiroshi
H
Morita
Kiyoshi
K
D000310:Adrenal Gland Neoplasms / Q000150:complications* / Q000601:surgery*; D000315:Adrenalectomy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods*; D010673:Pheochromocytoma / Q000150:complications* / Q000601:surgery*; D006435:Renal Dialysis