Anesthetic management in a patient with pheochromocytoma: a case report

Pheochromocytoma a tumor of the medullary layer of the adrenal gland composed of chromaffin cells that produces catecholamines (adrenaline, noradrenaline, and dopamine), is a special case of sympathetic paraganglioma.

Pheochromocytoma is a life-threatening catecholamine-secreting tumor of chromaffin cells, which requires early and timely diagnosis and treatment. he clinical manifestations of pheochromocytoma are arterial hypertension, headaches predominantly in the occipital region, palpitations, tachycardia and hyperhidrosis.

Anesthesiological support during surgeries for neoplasm removal (pheochromocytoma) is accompanied by life-threatening conditions in the perioperative period.

Purpose to the study – to present the peculiarities of perioperative period management in a patient with pheochromocytoma.

Materials and methods. A 17-year-old patient was diagnosed with pheochromocytoma of the right adrenal gland. After thorough preoperative preparation, surgical intervention in the volume of adrenalectomy was performed. Due to compliance with the modern strategy of anesthesiology adopted in our institution, the course of the postoperative period was stable. On the 3rd day after the operation the child was transferred to the specialized department, and on the 9th day he was discharged from the hospital under the dynamic observation of the endocrinologist at the place of residence. Event-free survival rate in the patient amounted to 82 weeks.

Conclusion. Thorough preoperative preparation of the patient with alpha1-adrenoblockers for 1 month, stabilization of hemodynamics in the perioperative period prevents life-threatening complications, such as hemodynamic disorders in the form of intraoperative hypertension and subsequent hypotension after clamping of tumor-feeding vessels, postoperative hypotension, within the framework of combined anesthesia using epidural analgesia.

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