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  • Title: Anaesthesia for phaeochromocytoma in pregnancy.
    Author: Hamilton A, Sirrs S, Schmidt N, Onrot J.
    Journal: Can J Anaesth; 1997 Jun; 44(6):654-7. PubMed ID: 9187786.
    Abstract:
    PURPOSE: Phaeochromocytoma in pregnancy is a rare occurrence. Details of the anaesthetic are even more rarely reported. Our purpose is to describe our management with reference to previous reports. CLINICAL FEATURES: A 31-yr-old woman underwent resection of a phaeochromocytoma at seven weeks gestation. Preoperative preparation included 2 mg prazosin p.o. bid and 40 mg propranolol p.o. bid. A balanced anaesthetic technique including 5 mg midazolam, 1500 micrograms alfentanil, 35 micrograms sufentanil, nitrous oxide and isoflurane was used. Blood pressure was controlled with 3.4 g magnesium and 2437 micrograms nitroglycerin. There were no episodes of hypertension intraoperatively. The patient made an uneventful recovery and delivered a normal baby at 37 wk gestation by caesarean section. CONCLUSION: Anaesthesia for resection of a phaeochromocytoma in early pregnancy can be successfully managed with preoperative alpha and beta sympathetic blockade and a balanced anaesthetic technique using magnesium as the main intraoperative hypotensive agent.
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