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Background Pheochromocytomas produce hormones, cytokines, and catecholamines. We report perioperative anesthetic management of a rare interleukin-6 (IL-6)-producing pheochromocytoma. Case presentation A 32-year-old female was scheduled for laparoscopic adrenalectomy for pheochromocytoma. She had a sustained high fever with elevated serum noradrenaline and IL-6 levels. The persistent high inflammatory state, followed by anemia, malnutrition, and coagulopathy, led us to prepone her date of surgery. During general anesthesia, alpha-blockers allowed hemodynamic fluctuations to be controlled. During surgery, simultaneous increases in noradrenaline and IL-6 levels were observed, which rapidly declined after tumor removal. Her postoperative course was uneventful, without pulmonary edema caused by cytokine storms. Conclusions The conventional pheochromocytoma strategy allowed surgical removal of an IL-6-producing pheochromocytoma under general anesthesia. However, management of high inflammatory states that induce anemia and coagulopathy is necessary.

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The goal of emergency cesarean sections is to deliver the newborn expeditiously while ensuring maternal safety. We devised a shared interdisciplinary protocol for emergency cesarean sections in our hospital with well-delineated directives for shortening the decision-to-delivery interval (DDI) .We investigated the value of the creation and implementation of the protocol by focusing on the DDI and its constituent elements before and after the protocol' s introduction. We found that the overall DDI and the time from entry to the operating theater to tracheal intubation were both significantly reduced after the protocol was instituted. Practicing of a protocol for emergency cesarean sections is useful for curtailing the DDI, and anesthesiologists can play a crucial role in this reduction.

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