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Canadian Journal of Anesthesia, Vol 17, 261-268, Copyright © 1970 by Canadian Anesthesiologists' Society

Anaesthetic Management of Pheochromocytoma: A Case Report

GARY L. FANNING M.D.1, MICHAEL H. M. DYKES M.B., B.CHIR.2, and ALLYN G. MAY M.D.3

1 Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Rochester, New York
2 Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, and Associate Surgeon, Strong Memorial Hospital, Rochester, New York
3 University of Rochester School of Medicine and Dentistry, and Associate Surgeon, Strong Memorial Hospital, Rochester, New York

The anaesthetic management of a patient with pheochromocytoma is discussed. The following points should be considered when treating such patients:

1. Preoperative preparation with adrenergic blocking agents, following the criteria of Harrison et al.4

2. Use of an anaesthetic agent (methoxyflurane or fluroxene) which is not associated with release of endogenous catecholamines and does not sensitize the myocardium to high levels of circulating catecholamines.

3. Adequate fluid and blood administration, including preoperative transfusion if necessary.

4. Careful monitoring during surgery, including direct arterial pressure, central venous pressure, electrocardiogram, urinary output, and blood gas determinations.

5. Ready availability of all pharmacological agents appropriate for the control of hypertension, hypotension, and cardiac arrhythmias.

Note:

Dr. Dykes is Assistant Professor of Anesthesiology; present address: Beth Israel Hospital, Boston, Massachusetts. Dr. May is Assistant Professor of Surgery, University of Rochester School of Medicine and Dentistry, and Associate Surgeon, Strong Memorial Hospital, Rochester, New York.






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