Was a hypertensive crisis in a patient with pheochromocytoma caused by rocuronium?: A case report |
Cheol Won Jeong, Hyung Gon Lee, Woong Mo Kim, Seung Heon Shin, Hong Beom Bae |
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea. nextphil2@freechal.com |
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Abstract |
Pheochromocytoma is an uncommon tumor that originates in the adrenal medulla or in other paraganglia of the sympathetic nervous system. If a hypertensive crisis occurs during general anesthesia in incidental or untreated pheochromocytoma, it is a life-threatening event with a mortality rate of about 80%. Anesthetic drugs such as pancuronium, atracurium, and metoclopromide can exacerbate the potentially lethal cardiovascular effects of catecholamines. We report a case of a patient with pheochromocytoma who display abrupt increases in systolic arterial pressure and plasma norepinephrine following rocuronium administration. This case indicates the possible involvement of elevated sympathetic nervous system to a catecholamine crisis triggered by rocuronium in pheochromocytoma. |
Key Words:
Catecholamine; Hypertensive crisis; Pheochoromocytoma; Rocuronium |
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