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Anesthesia for Pheochromocytoma

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Anesthesia for Urologic Surgery

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Abstract

Pheochromocytomas have an incidence of about 1–8 per million per year, and genetic studies have shown that approximately one third of patients have hereditary tumors or germ line mutations. The classical triad of presentation is paroxysmal sweating, hypertension, and headache. The activity of the sympathetic nervous system may be enhanced, and any trigger can potentially cause a malignant hypertensive crisis leading to fatal cerebrovascular accidents, dissecting aortic aneurysm, myocardial infarction, arrhythmia, and heart failure. The treatment of choice for adrenal tumors in general is surgical resection. Sustained norepinephrine release may lead to hypertrophic cardiomyopathy, a condition warranting tailored preoperative optimization. The events of greatest perioperative concern are anesthesia induction, insufflation of pneumoperitoneum, and tumor manipulation, but the mortality for scheduled pheochromocytoma resection is nowadays low.

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Authors and Affiliations

  1. Department of Surgical Sciences; Anesthesiology & Intensive Care, Uppsala University Hospital, Akademiska Sjukhuset, Uppsala, 751 85, Sweden

    Lennart Christiansson M.D., Ph.D., DEAA, EDIC, FCCP

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  1. Lennart Christiansson M.D., Ph.D., DEAA, EDIC, FCCP
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Correspondence to Lennart Christiansson M.D., Ph.D., DEAA, EDIC, FCCP .

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  1. Departments of Anesthesiology and Urolog, Icahn School of Medcine at Mount Sinai, New York, New York, USA

    Daniel M. Gainsburg

  2. The Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai Department of Anesthesiology, New York, New York, USA

    Ethan O. Bryson

  3. The Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai Department of Anesthesiology, New York, New York, USA

    Elizabeth A. M. Frost

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Christiansson, L. (2014). Anesthesia for Pheochromocytoma. In: Gainsburg, D., Bryson, E., Frost, E. (eds) Anesthesia for Urologic Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7363-3_8

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