| Anesthetic Management of a Patient with Pheochromocytoma. |
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Hye Won Lee, Joung Uk Kim, Hae Ja Lim, Byung Kook Chae, Seong Ho Chang, Jung Soon Shin |
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Department of Anesthesiology, College of Medicine, Korea University, Seoul, Korea. |
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| Abstract |
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Pheochromocytoma is functioning tumor which originates in the adrenal medulla or in chromaffin tissue along the paravertebral sympathetic chain. This tumor releases epinephrine and norepinephrine causing increase of peripheral resistance and resulting in increased blood pressure and reducing plasma volume. The anesthetic management of patients with pheochromocytoma presents many difficult problems such as hypertension, cardiac arrhythmias, and hypotension. A 40 year-old female underwent resection of pheochromocytoma under general anesthesia.
Thiopental was used for induction followed N2O-O2-enflurane supplemented with fractional doses of fentanyl and vecuronium for muscle relaxation. Hypertensive crisis during induction of anesthesia and surgical manipulation of the tumor were managed with phentolamine and sodium nitroprusside, and premature ventricular beats were controlled with lidocaine. We experienced marked fluctuation of blood pressure during anesthetic course. |
| Key Words:
Pheochromocytoma |
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