title: [Assessment of the perioperative factors contributing to the hemodynamic changes during surgery in ten patients with pheochromocytoma].
abstract: BACKGROUND
  Intensive perioperative management is required for adrenalectomy in patients with pheocromocytoma because of the unstable hemodynamics and life threatening cardiovascular disturbances due to catecholamine surge from the neuroendocrine tumors. The aim of this study was to assess the perioperative factors contributing to the hemodynamic changes during surgery in pheochromocytoma.
  
  
  METHODS
  Ten patients with pheochromocytoma undergoing elective adrenalectomy were enrolled in this retrospective study. The circulating blood volume before surgery and the perioperative factors associated with hemodynamic changes during surgery were assessd by the pulse dye densitometry and VigileoTM/ FroTracTM system, respectively.
  
  
  RESULTS
  The decreases of blood pressure after resections of the central veins from tumors were significantly greater in laparotomy than those in laparoscopic surgery (P<0.05). In addition, the decreases of blood pressure after resection of the central were correlated with tumor sizes (R= -0.611), perioperative noradrenaline (NA) blood levels (R= -0.860), perioperative amounts of NA in urine (R= -0.743), and mean stroke volume variations for 5 min after resection of the veins(R= - 0.679).
  
  
  CONCLUSIONS
  The decreases of blood pressure after resections of the central veins are dependent on the perioperative blood NA levels, the level of NA in the perioperative urine testig, and tumor sizes.
authors.affiliation: Department of Anesthesiology, Tohoku University Hospital, Sendai 980-8574.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Konno
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishino
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ejima
authors.forename: Eiko
authors.initials: E
authors.lastname: Ohnishi
authors.forename: Kuniko
authors.initials: K
authors.lastname: Sato
authors.forename: Shin
authors.initials: S
authors.lastname: Kurosawa
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000503:physiopathology / Q000601:surgery*; D000315:Adrenalectomy; D001794:Blood Pressure; D001810:Blood Volume; D006439:Hemodynamics; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D009638:Norepinephrine / Q000097:blood / Q000652:urine; D059035:Perioperative Period; D010673:Pheochromocytoma / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013318:Stroke Volume
chemical_list: D009638:Norepinephrine