Anaesthetic management of phaeochromocytoma

Canadian Anaesthetists' Society Journal
V Pratilas, M G Pratila

Abstract

The incidence, mortality, physiology, clinical findings and diagnosis of phaeochromocytoma are reviewed. Treatment, after adequate medical stabilization, must be surgical because of the high incidence of malignancy. Alpha-adrenergic receptor blockade and beta-adrenergic receptor blockade in the preoperative period was discussed. Anaesthetic management of patients with phaeochromocytoma requires close monitoring. Virtually all inhalational anaesthetic agents have been used in cases of phaeochromocytoma. Recent reports have favored enflurane. The merits of neuroleptanaesthesia and the various muscle relaxants are also discussed. Most authors favour lidocaine over propranolol for management of dysrhythmias during operation. Phentolamine or sodium nitroprusside are used for hypertension during operation. Hypotension is treated by fluid replacement with nor-epinephrine if a vasopressor becomes necessary. Close monitoring is necessary in the postoperative period. Adequate urinary output is of more importance than actual blood pressure levels.

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Citations

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Related Concepts

Sodium Nitroprusside
Intraoperative Care
Diastolic Blood Pressure
Enflurane
Neuroleptanalgesia
Muscle relaxants FOR TREATMENT OF HEMORRHOIDS AND ANAL FISSURES FOR TOPICAL USE
Insufflation Anesthesia
Adrenergic alpha-Antagonists
ADRB2 gene
Anesthesia, Intravenous

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