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Korean Journal of Anesthesiology 2009;57(2):249-253.
DOI: https://doi.org/10.4097/kjae.2009.57.2.249   
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
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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