| Halothane Anesthesia for Pheochromocytoma . |
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Jae Chull Kim, Jae Kyu Jeon |
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Department of Anesthesiology, Keimyung University Medical College and Hospital, Taegu, Korea. |
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| Abstract |
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Various anesthetic agents have been recommended for pheochromocytoma surgery. However, in general, no ideal anesthetic agent has been accepted as yet. The use of the well known agents, halothane still remains a contraversial issue for pheochromocytoma surgery. According to our experience and a review of the literature, it is strongly suggested that halothane is the anesthetic agent of choice among the anesthetic agents currently available. We believe that the incidence of arrythmia from halothane is not higher than that from other anesthetic agents and arrthmia is not caused primarily by halothane, but results mostly from endogenous catecholamines during surgery. In addition to these advantages, it is a rapid induction agent accompained by a peripheral vessel dilating effect. Lidocaine also is readily available to counteract the disadvantages of the arrythmic effect of halothane. We have had two uneventful cases of pheochromocytoma surgery. One was prepared with phenoxybeaxamine preoperatively and anesthetized with halothane. The other was not prepared with phenoxybeaxamine, but was anesthetized with halothane. The patient prepared with phenoxybeaxamine had prolonged hypotension for two days postoperatively and was treated with Neo-Synephrine drip.
However, the patient wihout preoperative phenoxybeaxamine had no problem with his blood pressure post operatively. As a result of this experience, we believe the preoperative use of phenoxybeaxamine is not necessary, plus it also creates more problems with postoperative hypotension. Halothane can act as a vasodilator in place of phenoxybeaxamine during anesthesia. Therefore, halothane is currently the ideal anesthetic agent of choice without phenoxybeaxamine preparation when lidocaine is available. |
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