Anesthetic management for resection of para-aortic paraganglioma and unexpected aortic resection: A case report

Experimental and Therapeutic Medicine
Cheryl WangEnas Eldesouki

Abstract

Paragangliomas account for 15-20% of pheochromocytomas derived from chromaffin cells and secretes catecholamines. It has a high mortality rate due to hypertension and challenging anesthetic management. The present report is of a case of the successful management of paraganglioma resection with unexpected aortic resection. The patient presented for paraganglioma resection. The blood pressure (BP) was well controlled with α blockade followed by β blockade prior to surgery. The patient was under general anesthesia, with multiple intravenous lines, catheters and an arterial line. Induction was achieved by the administration of narcotic and volatile agents. During the procedure, the aorta was found to require resection in order to complete the tumor resection. The BP changed markedly with clamping and unclamping, tumor vein ligation and tumor resection. The increased BP due to catecholamine release and unclamping was controlled with phentolamine, nitroprusside, esmolol and labetolol. Drops in BP due to tumor vein ligation and clamping were managed with norepinephrine and vasopressin. With close communication and monitoring, the surgery on the patient was successfully completed and the patient was discharged days later in a hemodynam...Continue Reading

References

May 30, 2006·The Annals of Thoracic Surgery·Frank W BowenThomas Gleason
Mar 29, 2011·International Anesthesiology Clinics·Izabela JugovacSandeep Markan
Mar 1, 2012·Journal of Cardiothoracic and Vascular Anesthesia·Michael S Lord, John G T Augoustides
Jan 30, 2014·Maturitas·A TsirlinM A Banerji
Mar 19, 2014·Current Problems in Surgery·Richard HodinAntonia Stephen
Mar 19, 2014·Current Problems in Cancer·Victoria L Martucci, Karel Pacak

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BETA
surgical resection
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