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Unresponsive asystolic cardiac arrest responding to external cardiac pacing in a patient with phaeochromocytoma
Author(s) -
Taylor M. J.,
McIndoe A.
Publication year - 2007
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.1365-2044.2007.05126.x
Subject(s) - medicine , phenoxybenzamine , doxazosin , pheochromocytoma , thoracic trauma , labetalol , anesthesia , antagonist , silodosin , cardiothoracic surgery , resuscitation , thoracotomy , propranolol , cardiology , surgery , blood pressure , receptor , cancer , blunt , lower urinary tract symptoms , prostate
Summary An anaesthetised 48‐year‐old woman became haemodynamically unstable following biopsy of a thoracic mass suggesting a diagnosis of a thoracic phaeochromocytoma. Surgery was postponed to allow confirmatory investigations and pre‐operative adrenoceptor blockade with phenoxybenzamine and labetalol. Nine days later, following resection of her phaeochromocytoma, she suffered an intra‐operative asystolic cardiac arrest which was unresponsive to standard resuscitation protocols and required external cardiac pacing. We discuss the issues involved and suggest that the competitive α 1 adrenoceptor antagonist doxazosin may be preferable to the covalently bound mixed alpha adrenoceptor antagonist phenoxybenzamine in the pre‐operative preparation of patients with phaeochromocytoma.