Anaesthetic Management of A Case of  Phaeochromocytoma Posted For Laparoscopic  Bilateral Adrenalectomy With Magnesium  Sulphate Infusion : A Case Report

Dr Deepa Chandran; Dr Joel Chakravarthy; Dr Varghese Zachariah

Volume : III, Issue : III, March - 2014

Anaesthetic Management of A Case of Phaeochromocytoma Posted For Laparoscopic Bilateral Adrenalectomy With Magnesium Sulphate Infusion : A Case Report

Dr Deepa Chandran, Dr Joel Chakravarthy, Dr Varghese Zachariah

Abstract :

Phaeochromocytoma is a rare catecholamine secreting neuroendocrine tumour commonly arising from the adrenal medulla. The classic triad of headache , palpitations and diaphoresis is present in 70% of patients and only 50% of the cases have sustained hypertension. The definitive treatment for phaeochromocytoma is surgical excision of the affected adrenal gland. The anaesthetic management is challenging as it is associated with wide haemodynamic fluctuations especially during induction, intubation , tumor handling and following tumour vessel ligation. There is wide institutional and global variation in the intraoperative anaesthetic technique and there is insufficient data to suggest one technique over the other. We hereby report a case of bilateral phaeochromocytoma in a 38 year male patient who underwent laparoscopic bilateral adrenalectomy for bilateral phaeochromocytoma. We successfully managed the case with intravenous magnesium sulphate infusion instituted intraoperatively, along with epidural infusion with minimal haemodynamic changes. The use of labetolol and sodium nitroprusside infusions was minimal.