Anesthesia management with short acting agents for bilateral pheochromocytoma removal in a 12‐year‐old boy

Bakan, Mefkür; Kaya, Güner; Çakmakkaya, Özlem Serpil; Tufanogullari, Burcu

doi:10.1111/j.1460-9592.2006.01979.x

Cited by 10 publications

(5 citation statements)

References 12 publications

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“…Although desflurane exerts sympathetic stimulation at an inspired concentration of 1.0-1.5 MAC [4], it is attenuated by a small dose of opioids [18]. Effective use of desflurane for controlling blood pressure during pheochromocytoma surgery and for rapid recovery from general anesthesia as a sole agent or in combination with remifentanil has been reported in a child as well as in adults [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Although desflurane elicits sympathetic activation, hypertension, and tachycardia when its inspired concentration exceeds 1.0 minimum alveolar concentration (MAC) [4], it provides faster and tighter hemodynamic control than other volatile agents at lower than 1.0 MAC [5,6], suggesting that desflurane might be safely used during anesthesia for resection of pheochromocytomas. However, there have been only a few reports describing anesthesia with desflurane in patients undergoing pheochromocytoma surgery [7][8][9]. We report the use of desflurane in a patient undergoing resection of extra-adrenal pheochromocytoma by laparotomy.…”

Section: Introductionmentioning

confidence: 99%

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Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Oda¹,

Adachi²,

Komatsu³

et al. 2018

JA Clin Rep

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Background: Although various agents are used during anesthesia for surgical resection of pheochromocytoma, application of desflurane has rarely been reported. We report the use of desflurane in a case receiving resection of extra-adrenal pheochromocytoma. Case presentation: A 51-year-old female was transferred to our hospital for sustained hypertension. A diagnosis of extra-adrenal pheochromocytoma was made based on increased plasma catecholamine levels and radiographic findings. Surgical resection was planned after controlling blood pressure. General anesthesia was induced with propofol and fentanyl, followed by maintenance with desflurane 4.3% and remifentanil 0.2-0.4 μg/kg/min. Blood pressure and heart rate were stable during induction, tracheal intubation, and tumor manipulation. Blood pressure abruptly decreased to 62/40 mmHg after removal of the tumor, which was treated with noradrenaline. The surgery was completed uneventfully and the postoperative course was also uneventful. Conclusion: Desflurane was safely used in combination with remifentanil during anesthesia for resection of extraadrenal pheochromocytoma.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Oda¹,

Adachi²,

Komatsu³

et al. 2018

JA Clin Rep

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“…Esmolol has a ultra-short elimination half-life and it may be particularly advantageous due to this characteristic. In several studies, esmolol has been used successfully to control of hypertension in the patients with pheochromocytoma [8][9][10] . In our case, we could not decrease blood pressure with sodium nitroglycerine and we provided better hemodynamic stability with esmolol.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of a child undergoing bilateral laparoscopic adrenalectomy

Türktan¹,

Alkan²,

Özcengiz³

2016

Cukurova Med J

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Pheochromocytoma is a rare catecholamine secreting neuroendocrine tumor in children. It is usually localized unilaterally in adults but often bilaterally in children. The symptoms are variable related to the level of secreted catecholamine. The most common symptoms are hypertension, tachycardia and headache. Beta blockers, alcohol consumption, injection of contrast substance and surgical procedures may lead to attacks. The most effective treatment is surgical resection. In recent years, laparoscopic surgery has been more preferred. Anesthetic management is very important in this cases. Especially, sudden hemodynamic changes may be observed during laparoscopic adrenalectomy. In our case, the control of hemodynamic changes with esmolol and norepinephrine infusion were discussed during bilaterally laparoscopic adrenalectomy in a 14-year old child with pheochromocytoma.Feokromasitoma, çocukluk çağında nadir görülen ve katekolamin salgılayan nöroendokrin bir tümördür. Erişkinde genellikle tek taraflı yerleşim gösterirken çocuklarda sıklıkla çift taraflıdır. Salgıladığı katekolamin miktarına bağlı olarak semptomlar değişkenlik gösterir. En sık görülen semptomlar; hipertansiyon, taşikardi ve baş ağrısıdır. Beta bloker kullanımı, alkol tüketimi, contrast madde enjeksiyonu ve cerrahi girişim atakları tetikleyebilir. Tedavisi cerrahidir ve son yıllarda laparoskopik yaklaşım daha fazla tercih edilmektedir. Bu olgularda hemodinamik değişiklikler nedeniyle anestezi yönetimi oldukça önemlidir. Özellikle laparoskopik adrenalektomi sırasında ani hemodinamik değişiklikler gözlenebilir. Olgumuzda, feokromasitoma nedeniyle bilateral laparoskopik adrenalektomi planlanan 14 yaşında erkek çocukta cerrahi sırasında gelişen hemodinamik değişikliklerin esmolol ve norepinefrin infüzyonu ile kontrolü tartışılmıştır.

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“…Although such crisis may be resolved by intraoperative phentolamine injections [2], agents of short action, like nitroprusside, landiolol and balanced general anesthesia using propofol and sevoflurane may improve hemodynamic management of phaeochromocytoma patients [18,21]. These agents could be applicable for immediate control of excessive blood pressure resulting not only from catecholamines secreted by phaeochromocytoma, but also due to the surgical manipulation of normal adrenal tissue and adrenal tumors [10].…”

Section: Discussionmentioning

confidence: 99%

Perioperative hypertension in phaeochromocytoma patients undergoing adrenalectomy

Šakić¹,

Kvolik²,

Grljusic

et al. 2007

Open Medicine

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AbstractThis study was designed to compare perioperative blood pressure (BP) management in hypertensive patients with phaeochromocytoma undergoing preoperative α-blockade and in patients with other suprarenal gland tumors. Perioperative hemodynamic data and immediate postoperative outcome in two groups undergoing adrenalectomy were compared. 483 medical charts from urologic patients with tumors were analyzed. In the hypertensive (n = 168) group, 20 patients with suprarenal gland tumors were identified (phaeochromocytoma n = 11, other tumors n = 9). Demographic data, intraoperative consumption of fentanyl and phentolamine, preoperative hospital stay and postoperative ICU stay were compared. Mean arterial pressure (MAP) was registered on the day before surgery, before anesthetic induction, during surgery, and upon admission in the intensive care unit (ICU). Although BP values did not differ significantly on the day before anesthesia, before induction and during operation, significantly more antihypertensive drugs were used for BP regulation in phaeochromocytoma patients versus the other tumor group. The phaeochromocytoma group required significantly more fentanyl during surgery (370±87 vs. 242±35 µg; p = 0.04). MAP upon ICU admission was significantly lower (85.1 vs. 97.4, p = 0.02) after adrenalectomy in phaeochromocytoma patients versus the other tumor group. The postoperative MAP decreased significantly in the phaeochromocytoma group (21.51 mmHg, p = 0.005), whereas significant differences according to preoperative values were not observed in the other tumor group (5.5 mmHg, p = 0.416). Prolonged preoperative hospital stay (24.6 vs. 10.0 days, p = 0.005) and ICU stay were registered in the phaeochromocytoma group. Pheochromocytoma patients had more pronounced perioperative BP oscillations, needed more antihypertensive drugs, analgesics and required prolonged hospital stay than patients with other adrenal tumors. Prolonged α-blockade may have contributed to these effects.

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Anesthesia management with short acting agents for bilateral pheochromocytoma removal in a 12‐year‐old boy

Cited by 10 publications

References 12 publications

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Anesthetic management of a child undergoing bilateral laparoscopic adrenalectomy

Perioperative hypertension in phaeochromocytoma patients undergoing adrenalectomy

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