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Canadian Journal of Anesthesia, Vol 44, 654-657, Copyright © 1997 by Canadian Anesthesiologists' Society

ARTICLES

Anaesthesia for phaeochromocytoma in pregnancy

A Hamilton, S Sirrs, N Schmidt and J Onrot
University of British Columbia Department of Anaesthesia, St Pauls' Hospital, Vancouver, Canada.

PURPOSE: Phaeochromocytoma in pregnancy is a rare occurrence. Details of the anaesthetic are even more rarely reported. Our purpose is to describe our management with reference to previous reports. CLINICAL FEATURES: A 31-yr-old woman underwent resection of a phaeochromocytoma at seven weeks gestation. Preoperative preparation included 2 mg prazosin p.o. bid and 40 mg propranolol p.o. bid. A balanced anaesthetic technique including 5 mg midazolam, 1500 micrograms alfentanil, 35 micrograms sufentanil, nitrous oxide and isoflurane was used. Blood pressure was controlled with 3.4 g magnesium and 2437 micrograms nitroglycerin. There were no episodes of hypertension intraoperatively. The patient made an uneventful recovery and delivered a normal baby at 37 wk gestation by caesarean section. CONCLUSION: Anaesthesia for resection of a phaeochromocytoma in early pregnancy can be successfully managed with preoperative alpha and beta sympathetic blockade and a balanced anaesthetic technique using magnesium as the main intraoperative hypotensive agent.


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Copyright © 1997 by the Canadian Anesthesiologists' Society.