Perioperative Management of Pheochromocytoma

Naranjo, Julian; Dodd, Sarah E; Martin, Yvette N.

doi:10.1053/j.jvca.2017.02.023

Cited by 155 publications

(201 citation statements)

References 135 publications

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“…Thus, no consensus has been reached about the criteria for HI. In our study, intraoperative HI was assessed using the definition of haemodynamic parameters determined from previous studies . Some recent studies suggest that HI should be defined as a morbidity‐related variable .…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative vasopressors and vasodilators, estimated blood loss, as well as infusion volume of colloid and crystalloid were evaluated. According to previous studies, intraoperative HI was defined as the presence of at least one intraoperative SBP >200 mm Hg episode and/or at least one intraoperative DBP <80 mm Hg episode . Postoperative complications were collected and classified using the Clavien‐Dindo classification …”

Section: Methodsmentioning

confidence: 99%

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Preoperative risk factors for haemodynamic instability during pheochromocytoma surgery in Chinese patients

Jiang

Ding

et al. 2018

Clinical Endocrinology

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HI is common among Chinese patients undergoing surgery for pheochromocytoma. Our study identified three predictive factors for intraoperative HI: a large tumour diameter, diabetes/prediabetes and a great preoperative systolic blood pressure fluctuation. Furthermore, patients are more likely to suffer from HI when they have more predictive risk factors. Identification of these risk factors can help to improve perioperative management.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Preoperative risk factors for haemodynamic instability during pheochromocytoma surgery in Chinese patients

Jiang

Ding

et al. 2018

Clinical Endocrinology

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“…The choice of anesthetic agent is generally less important than the depth of anesthesia for inhibiting adrenergic and cardiovascular responses [14]. Both inhalation and intravenous agents can be used, with an exception that morphine should be avoided due to its propensity to elicit histamine release [2,15].…”

Section: Discussionmentioning

confidence: 99%

“…2). Although hypotension frequently occurs after removal of pheochromocytoma, hypertension is also a common complication [14]. According to a longtime follow-up study, approximately 50% of patients were hypertensive after resection of pheochromocytoma without recurrence [19], which was ascribed to underlying predisposing essential hypertension.…”

Section: Discussionmentioning

confidence: 99%

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Oda¹,

Adachi²,

Komatsu³

et al. 2018

JA Clin Rep

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Background: Although various agents are used during anesthesia for surgical resection of pheochromocytoma, application of desflurane has rarely been reported. We report the use of desflurane in a case receiving resection of extra-adrenal pheochromocytoma. Case presentation: A 51-year-old female was transferred to our hospital for sustained hypertension. A diagnosis of extra-adrenal pheochromocytoma was made based on increased plasma catecholamine levels and radiographic findings. Surgical resection was planned after controlling blood pressure. General anesthesia was induced with propofol and fentanyl, followed by maintenance with desflurane 4.3% and remifentanil 0.2-0.4 μg/kg/min. Blood pressure and heart rate were stable during induction, tracheal intubation, and tumor manipulation. Blood pressure abruptly decreased to 62/40 mmHg after removal of the tumor, which was treated with noradrenaline. The surgery was completed uneventfully and the postoperative course was also uneventful. Conclusion: Desflurane was safely used in combination with remifentanil during anesthesia for resection of extraadrenal pheochromocytoma.

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“…Paroxysms can be exacerbated by many actions including, but not limited to, alcohol consumption, strenuous activity, micturition, defecation, labor and delivery, minor surgical procedures, and general anesthesia. Medications that can precipitate a catecholamine crisis include, but are not limited to, dopamine D2 receptor blockers, beta-adrenergic receptor blockers, opioids, sympathomimetics, anticholinergics, norepinephrine and serotonin reuptake inhibitors, monoamine oxidase inhibitors, corticosteroids, neuromuscular blocking agents, and peptides [adrenocorticotrophic hormone (ACTH) and glucagon] [2,[15][16][17][18]. Sequelae of excessive catecholamine secretion can include glucose intolerance, diabetes mellitus, myocardial infarction, heart failure, cerebrovascular accident (CVA), and death.…”

Section: Clinical Featuresmentioning

confidence: 99%

Precision Surgery for Pheochromocytomas and Paragangliomas

2019

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Since Felix Fränkel’s account of pheochromocytoma in 1886, great discoveries and vast advancements in the diagnosis, genetics, anatomical and functional imaging techniques, and surgical management of pheochromcytoma and paraganglioma (P-PGL) have been made. The improved insight in the pathophysiology of P-PGL and more accurate detection methods enable physicians to tailor the treatment plan to an individual based on the genetic profile and tumor behavior. This review will cover briefly the clinical features, diagnosis, genetic mutations, and imaging modalities that are used to guide current surgical management of these rare and interesting endocrinopathies.

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Perioperative Management of Pheochromocytoma

Cited by 155 publications

References 135 publications

Preoperative risk factors for haemodynamic instability during pheochromocytoma surgery in Chinese patients

Preoperative risk factors for haemodynamic instability during pheochromocytoma surgery in Chinese patients

Use of desflurane during anesthesia for resection of extra-adrenal pheochromocytoma: a case report

Precision Surgery for Pheochromocytomas and Paragangliomas

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