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Thoracic epidural analgesia in a patient with bilateral phaeochromocytoma undergoing coronary artery bypass grafting
Author(s) -
LIEM T. H.,
MOLL J. E.,
BOOIJ L. H. D. J.
Publication year - 1991
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.1991.tb09716.x
Subject(s) - medicine , sufentanil , anesthesia , artery , catecholamine , bypass grafting , hemodynamics , surgery
Summary A patient suffering from phaeochromocytoma and coronary artery stenoses needed coronary artery bypass grafting before adrenalectomy. High thoracic epidural analgesia (T 1 ‐T 2 ) with bupivacaine and sufentanil in combination with general anaesthesia was used. Plasma adrenaline and noradrenaline concentrations decreased during the period before bypass grafting compared to the baseline value and no important haemodynamic changes were seen during this period. Thoracic epidural analgesia failed to suppress the release of catecholamine during the bypass period. After the operation, the plasma catecholamine concentrations returned to the baseline value. Excellent analgesia (visual analogue scale = 1‐2) was achieved with a postoperative epidural, but the plasma catecholamine concentration increased considerably.