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Perioperative management of a child with severe hypertension from a catecholamine secreting neuroblastoma
Author(s) -
SEEFELDER CHRISTIAN,
SPARKS J. WILLIAM,
CHIRNOMAS DEBORAH,
DILLER LISA,
SHAMBERGER ROBERT C.
Publication year - 2005
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1111/j.1460-9592.2005.01631.x
Subject(s) - medicine , phenoxybenzamine , catecholamine , neuroblastoma , doxazosin , perioperative , pheochromocytoma , anesthesia , blood pressure , norepinephrine , surgery , dopamine , biology , propranolol , genetics , cell culture
Summary Increased catecholamine secretion from neuroblastomas can occasionally be demonstrated, but severe hypertension is uncommon. We report the perioperative management of a 5 year old child with stage III adrenal neuroblastoma who presented with malignant hypertension and high norepinephrine and dopamine levels. Hypertensive crises occurred during anesthesia for surgical biopsy and during chemotherapy. After blood pressure control using phenoxybenzamine and enalapril, doxazosin was used successfully as the preoperative α ‐adrenergic receptor antagonist for surgical tumor resection.