Assessment of serum catecholamine concentrations in patients with pheochromocytoma undergoing videolaparoscopic adrenalectomy

Abstract

Introduction: We analyzed the changes in serum catecholamine concentrations, i.e. adrenaline and noradrenaline, in response to surgical stress in patients with pheochromocytoma who undergone videolaparoscopic adrenalectomy.Materials and Methods: Between January 1998 and March 2002, 11 patients underwent 12 videolaparoscopic adrenalectomies. In one case, the adrenalectomy was bilateral. Serum catecholamines were measured at 6 surgical times: T0: control before induction; T1: following the induction, laryngoscopy and intubation sequence; T2: after installing the pneumoperitoneum; T3: during manipulation-exeresis of the pheochromocytoma; T4: following ablation of the pheochromocytoma; T5: in the recovery room following intervention when the patient was extubated and was hemodynamically stable.Results: Mean concentrations of serum noradrenaline were significantly different when the T0 and T2 surgical times were compared (T0: 3161 pg/mL; T2: 40440 pg/mL; p < 0.01), T0 and T3 (T0: 3161 pg/mL; T3: 46021 pg/mL; p < 0.001), T1 and T3 (T1: 5531 pg/mL; T3: 46021 pg/mL; p < 0.01), T2 and T4 (T2: 40440 pg/mL; T4: 10773 pg/mL; p < 0.01) and T3 and T5 (T3: 46021 pg/ mL; T5: 2549 pg/mL; p < 0.001). Mean concentrations of serum adrenaline were significantly different when the T0 and T3 surgical times were compared (T0: 738 pg/mL; T3: 27561 pg/mL; p < 0.01).Conclusion: The pneumoperitoneum significantly increases serum noradrenaline concentrations, manipulation of the adrenal gland significantly increases the serum concentrations of noradrenaline and adrenaline, and the pheochromocytoma ablation significantly decreases serum noradrenaline concentrations.

Intraoperative Serum Catecholamine Levels in a Pregnant Woman With Pheochromocytoma Undergoing Cesarean Delivery With Combined Spinal-Epidural Anesthesia: A Case Report

“…Previous studies in laparoscopic surgery have demonstrated that catecholamine secretion increases when IAP exceeds approximately 15 mmHg [ 14 ]. In addition, in patients with pheochromocytoma undergoing laparoscopic adrenalectomy, pneumoperitoneum induced a significant increase in serum catecholamine concentrations, especially with surgical stress during manipulation of the adrenal gland, which also promoted a significant increase [ 15 ]. This suggests that in pregnant women with catecholamine-producing tumors, maternal circulating catecholamine levels may rise and symptoms may worsen owing to the growing uterus, fetal movement, uterine contractions, and palpation of the abdomen [ 3 , 16 ].…”

“…In general anesthesia, analgesia with sufficient blockade of afferent input, as with the use of high-dose remifentanil, is necessary due to the hemodynamic changes induced. Hypertension should be prevented and treated with vasodilators [ 15 , 19 ]. However, no agent can completely prevent the hemodynamic changes.…”

Hemodynamic instability during percutaneous ablation of extra-adrenal metastases of pheochromocytoma and paragangliomas: a case series

“…Hemodynamic volatility is common during open or laparoscopic PPGL resection. The concentration of catecholamines in PPGL tumors may be high [ 21 ], and intraoperative catecholamine surge has been observed during surgical adrenalectomy of not only functional PPGLs [ 22 ] but also PPGLs with negative biochemistry [ 9 , 23 – 25 ]. Healthy adrenal glands contain an abundance of catecholamines, and percutaneous ablation of normal adrenal parenchyma can induce their release.…”

Effects of α and β-adrenergic signaling on innate immunity and Porphyromonas gingivalis virulence in an invertebrate model

“…To assess if the ligands were toxic for G. mellonella , a wide range of ISO (Isoproterenol hydrochloride, Sigma, I6504), NE (Noradrenaline tartrate, Sigma, N1100000), and OCT (Octopamine hydrochloride, Sigma, O0250) concentrations were injected into the last right proleg of the larvae. Concentrations were selected based on serum levels of NE in humans and OCT in insects during physiological, stress and pathological (pheochromocytoma) states [ 16–18 , 29 , 30 , 52 , 53 ]. The larvae were inoculated with 10 µL of ISO/NE/OCT or PBS, which served as the negative control.…”