Open AccessChild with bilateral pheochromocytoma and a surgically solitary kidney: Anesthetic challenges
Author(s) -
Manjunath Prabhu,
Tim Thomas Joseph,
Smiti Nanda,
Souvik Chaudhuri
Publication year - 2013
Publication title -
saudi journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.416
H-Index - 24
eISSN - 1658-354X
pISSN - 0975-3125
DOI - 10.4103/1658-354x.114051
Subject(s) - medicine , esmolol , pheochromocytoma , dexmedetomidine , anesthesia , nicardipine , blood pressure , nephrectomy , surgery , urology , kidney , heart rate , sedation
Pheochromocytoma is a rare neuroendocrine tumor of childhood. We present a 14-year-old boy with bilateral pheochromocytoma, post nephrectomy in view of a non-functioning kidney presenting with severe hypertension and end organ damage. Diagnosis was confirmed with 24-hour urinary VMA, catechol amines, and CT scan. Preoperative blood pressure (BP) was controlled with prazosin, propranolol, nicardipine, and HCT-spironolactone. Anesthesia was given with general endotracheal anesthesia with epidural analgesia. Intraoperative BP rise was managed with infusion of NTG, MgSO4, esmolol, and dexmedetomidine which was especially challenging on account of bilateral tumor.