| Acute Pulmonary Edema for Surgical Removal of Pheochromocytoma: A case report. |
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Cheol Kun Kim, Sang Ji Han, Jun Hak Lee, Young Eun Kwon |
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Department of Anesthesiology and Pain Medicine, Presbyterian Medical Center, Jeonju, Korea. kwon8373@yahoo.co.kr |
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| Abstract |
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This report describes the perioperative management of an adrenergic crisis and intraoperative pulmonary edema occurring during planned surgery for pheochromocytoma. We experienced the anesthetic management of a 45-year-old male patient with pheochromocytoma on the extra-adrenal retroperitoneum. The patient had been treated with prazosin for only 1 week before surgery. After inducing anesthesia with intravenous remifentanil, thiopental sodium, and rocuronium, anesthesia was maintained with nitrous oxide, oxygen, and isoflurane administration. The blood pressure was poorly controlled with sodium nitroprusside, esmolol, and remifentanil after manipulating the tumor. Pulmonary edema occurred intraoperatively but subsided with positive end expiratory pressure and the use of diuretics and morphine. After removing the tumor, the blood pressure was well controlled using a colloid solution, Hartman's solution, and dopamine administration. This complication occurred because of inadequate preoperative preparation. We reported this case of surgery for the removal of a pheochromocytoma with a review of the relevant literature. |
| Key Words:
pheochromocytoma; prazosin; pulmonary edema |
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