Anesthetic management of a patient with pheochromocytoma and cerebral ischemic attacks
Amano, A.; Shimoda, O.; Ikuta, Y.; Terasaki, H.
Masui. Japanese Journal of Anesthesiology 50(2): 192-194
2001
ISSN/ISBN: 0021-4892 PMID: 11244778 Document Number: 536535
A 15-year-old girl with history of two cerebral ischemic attacks possibly caused by cerebral vascular spasm was diagnosed as having a pheo-chromocytoma, and was scheduled for laparoscopic removal of the adrenal tumor. Epidural catheterization was performed at Th 12/L 1. General anesthesia was induced with thiamylal and vecuronium, and maintained with nitrous oxide-oxygen-isoflurane and continuous epidural infusion of 1.5% lidocaine. Phentolamine and thiamylal were continuously administrated into the vein. While operating on the tumor, abnormal hypertension did not occur. Just after removal of the tumor, the systolic blood pressure fell to 50-70 mmHg. The hypotension continued for about 75 min, despite administration of dopamine, norepinephrine and epinephrine. After the emergence from anesthesia, the blood pressure recovered to normal level. No neurocerebral abnormality was found. In patients like this one, we have to prevent cerebral vascular spasm and cerebral infarction caused by excessive secretion of catecholamines.