Rapid preparation of a patient with pheochromocytoma with labetolol and magnesium sulfate

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
R Poopalalingam, E Y Chin

Abstract

To describe the rapid perioperative optimization and control of blood pressure in a young patient who presented with pheochromocytoma. He was non-compliant with phenoxybenzamine but insisted on early surgery. He was scheduled for laparoscopic resection of the tumour. This 32-yr-old man presented with uncontrolled hypertension for a few years for which he was treated with nifedipine. He subsequently defaulted follow-up. The patient presented again approximately three months from the day of surgery and was diagnosed to have a pheochromocytoma. The endocrinologist prescribed phenoxybenzamine and propanolol in addition to the nifedipine but the patient stopped taking both drugs six weeks prior to surgery due to their side effects. The patient was admitted the evening before surgery to the intensive care unit for rapid control of his blood pressure. Blood pressure was optimized with an infusion of labetolol and volume expansion titrated under central venous catheter and intraarterial blood pressure guidance throughout the night. On the morning of surgery, a magnesium sulfate infusion was started. The laparoscopic surgery proceeded uneventfully and the patient was hemodynamically stable. There were two transient periods of hypotensio...Continue Reading

References

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Citations

Mar 11, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Colin M GoutcherAnne M Burke
Sep 11, 2012·Nigerian Journal of Clinical Practice·R Domi, H Laho
Jun 27, 2006·International Journal of Obstetric Anesthesia·J G HudsmithD A Browne
Jun 8, 2011·European Journal of Endocrinology·Claude LentschenerBertrand Dousset
Aug 31, 2004·Anesthesia and Analgesia·Michael F James, Larissa Cronjé
Feb 12, 2010·Journal of Pediatric Hematology/oncology·Lisbeth PappasChristian Seefelder
Sep 14, 2019·Endocrine Regulations·Frederick-Anthony Farrugia, Anestis Charalampopoulos
Jan 18, 2019·Clinical Medicine : Journal of the Royal College of Physicians of London·Sam M O'TooleWilliam M Drake

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