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H. Bruynzeel, R. A. Feelders, T. H. Groenland, A. H. van den Meiracker, C. H. van Eijck, J. F. Lange, W. W. de Herder and G. Kazemier, “Risk Factors for Hemodynamic Instability during Surgery for Pheochromocytoma,” Journal of Clinical Endocrinology & Metabolism, Vol. 95, 2010, pp. 678-685. doi:10.1210/jc.2009-1051

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• TITLE: Pheochromocytoma Anesthetic Management

  AUTHORS: Daniel D. Kim, Christiano Matsui, Judymara L. Gozzani, Ligia A. S. T. Mathias

  KEYWORDS: Pheochromocytoma; Anesthesia Management

  JOURNAL NAME: Open Journal of Anesthesiology, Vol.3 No.3, May 13, 2013

  ABSTRACT: Pheochromocytomas are catecholamine producing tumors and although uncommon present a great challenge to the anesthesiologist since it has nonspecific clinical symptoms and risk of critical events, including death when not previously diagnosed. Clinical manifestation is variable, unspecific and depends on the catecholamine production profile. The classic triad of headache, palpitation and diaphoresis is present in up to 70% of the cases and only 50% have sustained hypertension. The best approach for pheochromocytoma treatment is surgical excision of the affected adrenal gland. The introduction of alpha adrenergic blockade medication, such as phentolamine and phenoxybenzamine had the highest impact in perioperative mortality reduction due to inhibition of the deleterious effect of vasoconstriction. The majority of anesthetic techniques and drugs are considered safe. Post-operative care in intensive care unit is advisable since patients may present instability of blood pressure and hypoglycemia. Genetic testing should be done in first-degree relatives of confirmed cases or when a genetic syndrome is suspected.