Anaesthetic Management of a Case of Pheochromocytoma

Abstract

Pheochromocytoma is rare, accounting for less than 0.1 % of hypertensive population. In this report, we
describe a 40-year-old male a diagnosed case of pheochromocytoma who underwent adrenalectomy
under general anaesthesia with epidural analgesia. The patient was adequately prepared with alpha
adrenergic blockers. Intraoperative course was stormy but was managed with antihypertensives,
inotropes and intravenous fluid. The patient was electively ventilated overnight and had an uncomplicated
recovery.
Pheochromocytoma is a rare medical condition and an anaesthesiologist comes across it only a few times
in his or her practice. Therefore there is a limited exposure in management. Furthermore hemodynamic
instability encountered intra and postoperatively itself is a challenge. Hence management of a case of
pheochromocytoma demands a meticulous preoperative preparation, advanced monitoring devices and
good interdepartment coordination preferably in a tertiary medical center for a favourable outcome.

Key words: Haemodynamic instability; inotropes; pheochromocytoma; Sodium Nitroprusside.

DOI:  10.3126/mjsbh.v9i1.3486

Medical Journal of Shree Birendra Hospital Vol.9(1) 2010 19-23