Paroxysmal Tachycardia and Hypertension with or without Ventricular Fibrillation during Laparoscopic Adrenalectomy: Two Case Reports in Patients with Noncatecholamine-Secreting Adrenocortical Adenomas

Abstract

We present two cases of sudden unanticipated cardiovascular complications in patients with noncatecholamine-secreting adrenocortical adenomas during laparoscopic adrenalectomy. In the first case, the patient developed paroxysmal tachycardia and hypertension followed by ventricular fibrillation shortly after clipping of the adrenal vein. In the second case, the patient suffered hypertension and bigeminy during manipulation of the adrenal gland just around the adrenal vein. Awareness of such complications during either conventional or laparoscopic adrenalectomy is important even if the operation is performed in a patient with an apparently noncatecholamine-secreting adrenocortical adenoma.

Anesthesia for laparoscopy: a review

“…Tachyarrhythmias can occur because of increased concentrations of carbon dioxide and catecholamines. Paroxysmal tachycardia and hypertension, followed by ventricular fibrillation, have been reported during laparoscopic adrenalectomy [20]. The induction of pneumoperitoneum with the patient in the horizontal position rather than in head-up or head-down position can decrease the severity of these hemodynamic changes.…”

Anesthetic Management for Laparoscopic Cholecystectomy

“…Increased concentrations of CO 2 and catecholamines can create tachyarrhythmias. Paroxysmal tachycardia and hypertension, followed by ventricular fibrillation, have been reported [12].…”

Anesthetic Consideration For Laparoscopic Surgery Research

“…Increased concentrations of CO 2 and catecholamines can create tachyarrhythmias. Paroxysmal tachycardia and hypertension, followed by ventricular fibrillation, have been reported [8].…”