| Anesthetic Management of a Surgery for Pheochromocytoma in a Patient without Pharmacologic Pretreatment |
| 크롬친화세포종 수술의 마취 관리 |
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김현지; 김형동; 황일선; 강구정 |
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| Abstract |
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Normotensive pheochromocytoma as incidentaloma detected during the surgery is a challenge for
the anesthesiologists, despite the advent of new drugs. A 53-year-old female patient was
referred for removal of a deep mesenteric mass suspected mucinous cyctic tumor. She was in
normal range of blood pressure and on medications for hyperthyroidism. There was a surge of
systolic blood pressure when the tumor was manipulated in the operation field, and extreme
fluctuations in blood pressure prevented the continuous infusion of intravenous antihypertensive
drugs. After ligation of the draining vein, decreased blood pressure needed
v a s o p r e s s o r s. P a t h o l o g i c e x a m i n a t i o n o f t h e t i s s u e c o n f i r m e d t h e p r e s e n c e o f
pheochromocytoma. Preoperative management using α-adrenergic blockade is helpful for
abating hypertensive crisis during the surgery. When pheochromocytoma is suspected due to
sudden surge of blood pressure during the surgery, prompt and proper choices in the
management of blood pressure and volume status should be conducted and surgical method of
ligating draining vein may be needed. |
| Key Words:
Anesthesia,
Pheochromocytoma |
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