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We identified all the patients that underwent resection of catecholamine secreting phaeochromocytoma or paraganglioma at St Bartholomew’s Hospital, London. Of 41 patients with phaeochromocytoma or paraganglioma seen between 2009-2012, 19 patients were included in this retrospective audit. The pre-, periand post-operative medical, surgical, nursing, anaesthetic and fluid balance records of all 19 patients were reviewed. Patients were only included if the same surgeon (RAC) and anaesthetist (MA) were present. Patients who required blood transfusions were excluded from this study. All patients had alpha blockade with oral phenoxybenzamine for at least 3 weeks prior to surgery. In the immediate 3-day pre-operative period 5 patients had accelerated oral phenoxybenzamine therapy +/intravenous fluids and 14 patients had intravenous phenoxybenzamine +/intravenous fluid. We assessed intraoperative parameters of alpha blockade efficacy including requirement for sodium nitroprusside (SNP) and intravenous fluids. We assessed postoperative fluid requirement, use of and response to adrenaline, blood pressure and heart rate variability. Methods

Peri-operative [a]-blockade: efficacy of intravenous phenoxybenzamine vs oral phenoxybenzamine in patients with phaeochromocytoma and paraganglioma