Anaesthesia for phaeochromocytoma in pregnancy

Abstract

Purpose: Phaeochromocytoma in pregnancy is a rare occurrence. Details of the anaesthetic are even more rarely reported. Our purpose is to describe our management with reference to previous reports. Clinical features: A 31-yr- old woman underwent resection of a pnaeochromocytoma at seven weeks gestation. Preoperative preparation included 2 mg prazosin po bid and 40 mg propranolol po bid. A balanced anaesthetic technique including 5 mg midazolam, 1500 μg alfentanil, 35 μg sufentanil, nitrous oxide and isoflurane was used. Blood pressure was controlled with 3.4 g magnesium and 2437 μg nitroglycerin. There were no episodes of hypertension intraoperatively. The patient made an uneventful recovery arid delivered a normal baby at 37 wk gestation by caesarean section. Conclusion: Anaesthesia for resection of a phaeochromocytoma in early, pregnancy can be successfully managed with preoperative alpha and beta sympathetic blockade and a balanced anaesthetic technique using magnesium as the main intraoperative hypotensive agent.