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Pheochromocytoma and anesthesia

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https://www.readbyqxmd.com/read/29466473/combined-epidural-general-anesthesia-was-associated-with-lower-risk-of-postoperative-complications-in-patients-undergoing-open-abdominal-surgery-for-pheochromocytoma-a-retrospective-cohort-study
#1
Nan Li, Hao Kong, Shuang-Ling Li, Sai-Nan Zhu, Dong-Xin Wang
BACKGROUND: Current evidences show that regional anesthesia is associated with decreased risk of complications after major surgery. However, the effects of combined regional-general anesthesia remain controversial. The purpose of our study was to analyze the impact of anesthesia (combined epidural-general anesthesia vs. general anesthesia) on the risk of postoperative complications in patients undergoing open surgery for pheochromocytoma. METHODS: This was a retrospective cohort study...
2018: PloS One
https://www.readbyqxmd.com/read/29404657/catecholamine-crisis-during-induction-of-general-anesthesia-a%C3%A2-case-report
#2
M Sonntagbauer, A Koch, U Strouhal, K Zacharowski, C F Weber
Catecholamine crises associated with pheochromocytoma may cause life-threatening cardiovascular conditions. We report the case of a 75-year-old male who developed a hypertensive crisis during induction of general anesthesia for elective resection of a cervical neuroma due to an undiagnosed pheochromocytoma. Hemodynamic instability occurred immediately after the injection of fentanyl, propofol and rocuronium, prior to laryngoscopy and in the absence of any manipulation of the abdomen. In this case report, we present the management of this incident and discuss the underlying pathophysiology triggering a catecholamine crisis...
February 5, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29317965/perioperative-anesthetic-management-of-a-case-of-rare-ectopic-pheochromocytoma
#3
Aihua Jiang, Haiqiao Zhang, Xiaofei Liu, Huishan Zhao
We report an unusual case of pheochromacytoma and investigate the perioperative anesthetic management methods for giant abdominal aortic pheochromocytoma. We analyzed and summarized the recent clinical anesthetic management and experience in the hospital for a giant abdominal aortic pheochromocytoma, with the size of 20 × 14 × 5 cm. Under general anesthesia combined with TAPB, the resection of the giant abdominal aorta pheochromocytoma was successfully completed, and the patient was cured and discharged. Well planned and careful management resulted in patient with stable blood pressure, blood volume and cardiac functions, free from complications...
December 2017: World Journal of Oncology
https://www.readbyqxmd.com/read/29122324/hemodynamic-instability-during-surgery-for-pheochromocytoma-comparing-the-transperitoneal-and-retroperitoneal-approach-in-a-multicenter-analysis-of-341-patients
#4
MULTICENTER STUDY
Wessel M C M Vorselaars, Emily L Postma, Eric Mirallie, Julien Thiery, Mattan Lustgarten, Jesse D Pasternak, Rocco Bellantone, Marco Raffaelli, Thomas Fahey, Menno R Vriens, Laurent Bresler, Laurent Brunaud, Rasa Zarnegar
BACKGROUND: Intraoperative hemodynamic instability is a major challenge during adrenalectomy for pheochromocytoma. Typically, pheochromocytoma is performed laparoscopically either through the retroperitoneal or transperitoneal approach. We aimed to determine if the operative approach affects intraoperative hemodynamic instability during surgery for pheochromocytoma in a large multicenter multicenter cohort. METHODS: Retrospective, multicenter analysis of consecutive patients with pheochromocytoma who underwent total unilateral laparoscopic adrenalectomy without conversion were included...
January 2018: Surgery
https://www.readbyqxmd.com/read/29108378/preoperative-risk-factors-for-massive-blood-loss-in-adrenalectomy-for-pheochromocytoma
#5
Hongju Liu, Bin Li, Xuerong Yu, Yuguang Huang
Background: This retrospective analysis of patients who underwent adrenalectomy for pheochromocytoma aimed to determine preoperative risk factors for intraoperative massive blood loss. Preoperative identification of patients at high-risk of massive blood loss may be helpful in anesthesia management and preoperative preparation. Materials and Methods: The study involved data of 268 patients who had undergone pheochromocytoma surgery at the Peking Union Medical College Hospital between January 1, 2013 and October 31, 2016...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29041921/perioperative-management-of-paraganglioma-and-catecholamine-induced-cardiomyopathy-in-child-a-case-report-and-review-of-the-literature
#6
Xixi Jia, Xiangyang Guo, Qing Zheng
BACKGROUND: Paragangliomas are catecholamine-secreting tumors of the paraganglia. Perioperative mortality of children with paraganglioma is high, but preoperative therapy and anesthetic management of paraganglioma resection are controversial in children. The literatures on catecholamine-induced cardiomyopathy are limited to several case reports,with few reports of studies on children. CASE PRESENTATION: Here we report the anesthetic management of a child with paraganglioma and catecholamine-induced cardiomyopathy, and the possible perioperative anesthesia problems of the paraganglioma resection are discussed...
October 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28665830/undiagnosed-pheochromocytoma-simulating-malignant-hyperthermia
#7
Nisha S Ramani, Robert Stoppacher, Ajaykumar C Morani, Charles Catanese
INTRODUCTION: Pheochromocytomas are rare catecholamine-producing neuroendocrine tumors. They are surgically curable but can be lethal if remain undiagnosed. We report a patient earlier diagnosed with malignant hyperthermia but later found to have pheochromocytoma on autopsy. CASE REPORT: After a preprocedural pain block for elective right shoulder arthroscopy, a 53-year-old hypertensive white man developed chest pain. In the operating room, he had increased blood pressure...
September 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28197025/current-perioperative-management-of-pheochromocytomas
#8
REVIEW
Rashmi Ramachandran, Vimi Rewari
Neuroendocrine tumors which have the potential to secrete catecholamines are either associated with sympathetic adrenal (pheochromocytoma) or nonadrenal (paraganglioma) tissue. Surgical removal of these tumors is always indicated to cure and prevent cardiovascular and other organ system complications associated with catecholamine excess. Some of these tumors have malignant potential as well. The diagnosis, localization and anatomical delineation of these tumors involve measurement of catecholamines and their metabolic end products in plasma and urine, (123)I-metaiodobenzylguanidine scintigraphy, computed tomography, and/or magnetic resonance imaging...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/27994341/anesthetic-management-of-clinically-silent-familial-pheochromocytoma-with-men-2a-a-report-of-four-cases
#9
Shipra Aggarwal, Vandana Talwar, Pooja Virmani, Suniti Kale
Familial pheochromocytomas are commonly associated with multiple endocrine neoplasia type 2 (MEN 2) syndrome. Majority of the patients present with normal clinical and biochemical parameters in the preoperative period, the incidence of hypertension being only 50 %. Even though patients may be clinically asymptomatic, surveillance and proper preoperative evaluation is important, as surgery for associated tumors may precipitate a hypertensive crisis and result in severe complications. A family of 19 members, of which 12 were positive for MEN 2A syndrome, presented to our hospital...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27687340/anesthetic-management-of-a-myotonic-dystrophy-patient-with-paraganglionoma
#10
Ashwin Subramaniam, Robert Grauer, David Beilby, Ravindranath Tiruvoipati
Myotonic dystrophy (DM), though rare, can significantly complicate anesthesia due to muscular and extra-muscular involvement. When this condition is compounded by a pheochromocytoma, anesthetizing such patients becomes extra challenging. We present a case report of a 61-year-old lady with congenital DM, with the whole gamut of associated features, was diagnosed with a noradrenaline secreting paraganglionoma following investigation of refractory hypertension. We anesthetized her for an open resection of the lesion...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27561909/selective-versus-non-selective-%C3%AE-blockade-prior-to-laparoscopic-adrenalectomy-for-pheochromocytoma
#11
Reese W Randle, Courtney J Balentine, Susan C Pitt, David F Schneider, Rebecca S Sippel
BACKGROUND: The optimal preoperative α-blockade strategy is debated for patients undergoing laparoscopic adrenalectomy for pheochromocytomas. We evaluated the impact of selective versus non-selective α-blockade on intraoperative hemodynamics and postoperative outcomes. METHODS: We identified patients having laparoscopic adrenalectomy for pheochromocytomas from 2001 to 2015. As a marker of overall intraoperative hemodynamics, we combined systolic blood pressure (SBP) > 200, SBP < 80, SBP < 80 and >200, pulse > 120, vasopressor infusion, and vasodilator infusion into a single variable...
January 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27324891/takotsubo-cardiomyopathy-and-its-relevance-to-anesthesiology-a-narrative-review
#12
REVIEW
Eugene A Hessel
PURPOSE: Takotsubo cardiomyopathy (TTCM) is a form of stress cardiomyopathy that may occur in the perioperative period and among the critically ill. Therefore, anesthesiologists should be aware of its diagnosis and treatment. The aim of this narrative review is describe the features of TTCM and its relevance to the practice of anesthesiology. PRINCIPAL FINDINGS: Takotsubo cardiomyopathy occurs in about 2-9/100,000 persons in the general population annually and may occur in up to one in 6,700 cases in the perioperative period...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27172533/retroperitoneal-functioning-paraganglioma-a-rare-case-of-secondary-diabetes
#13
Radu Mihail Mirica, Octav Ginghina, Gabriela Zugravu, Razvan Iosifescu, Mihai Ionescu, Anca Ichiman, Adrian Rosca, Alexandra Mirica, Nicolae Iordache, Rubin Munteanu
INTRODUCTION: Paragangliomas are rare neuroendocrine tumors that arise from the extra-adrenal autonomic paraganglia, which can derive from either parasympathetic or sympathetic paraganglia and are closely related to pheochromocytomas. CASE REPORT: We present the case of a young male patient of 37 years old, who was admitted for hypertensive crisis and palpitations. His medical history included medically controlled type 2 diabetes mellitus, (diagnosed 10 months ago), Hepatitis A...
March 2016: Chirurgia
https://www.readbyqxmd.com/read/27097513/-a-case-of-rocuronium-induced-anaphylaxis-in-which-surgery-was-subsequently-performed-under-general-anesthesia-without-neuromuscular-blocking-agents
#14
Tatsuo Horiuchi, Tomonori Takazawa, Shigeru Saito
We report here a case of rocuronium-induced anaphylactic shock in a 41-year-old woman. She was scheduled for partial hepatectomy due to liver metastasis of a pheochromocytoma. Anesthesia was induced with propofol, remifentanil, and rocuronium. Bag-mask ventilation was difficult, and her blood pressure fell to around 40 mmHg just after induction. Subsequently, her trachea was intubated and adrenaline was injected. However, due to the subsequent persistence of severe hypotension and hypoxia, cardiopulmonary resuscitation was necessary...
March 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26790322/-relationship-between-the-landiolol-dose-and-urinary-catecholamine-metabolites-in-the-perioperative-management-of-patients-undergoing-pheochromocytoma-resection
#15
Keitaro Tachi, Shinji Takahashi, Makoto Tanaka
BACKGROUND: The amount of urinary catecholamine metabolites (metanephrine and normetanephrine) excreted in 24 hours correlates with catecholamine secretion by pheochromocytoma in a day and is considered an indicator of the strength of its hormonal activity. We investigated the existence of a relationship between the landiolol dose and urinary catecholamine metabolites in the perioperative management of patients with pheochromocytoma. METHODS: We retrospectively investigated the medical and anesthesia records of patients treated at University of Tsukuba Hospital between December 2007 and June 2012...
December 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26677525/management-of-pheochromocytoma-in-the-absence-of-alpha-blokers-a-case-report-from-ayder-referral-hospital
#16
Reiye Esayas Mengesha, Reintraut Brumeister Rother
A 13-year-old girl with right adrenal pheochromocytoma pretreated with Nifedipine, underwent surgical removal of the tumor. General anesthesia with Propofol infusion and pethidine analgesia was performed. To control the blood pressure (BP), Nitroglycerine infusions were administered successfully. Following the ligation of the adrenal veins, patient was hypotensive and inotropic support was required. This case report showed that in the absence of alpha blockers and short acting drugs the surgery could be done with a very good follow up and Nitroglycerine as antihypertensive...
July 2015: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/26466501/-a-case-of-undiagnosed-extra-adrenal-pheochromocytoma-in-an-adult-patient-with-single-ventricle-circulation-after-the-bidirectional-glenn-operation
#17
Masaki Kohno, Yusuke Nagamine, Takahisa Goto
We experienced a case of undiagnosed extra-adrenal pheochromocytoma in an adult patient with single ventricle circulation after the bidirectional Glenn operation. A 32-year-old woman was scheduled for open abdominal surgery for incidental retroperitoneal tumor. She had undergone the bidirectional Glenn operation for complex congenital heart disease consisting of double outlet right ventricle, ventricular septal defect, and pulmonary artery stenosis. She had not undergone the Fontan operation because of insufficient development of pulmonary circulation...
September 2015: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26092019/predictive-factors-for-postoperative-morbidity-after-laparoscopic-adrenalectomy-for-pheochromocytoma-a-multicenter-retrospective-analysis-in-225-patients
#18
MULTICENTER STUDY
Laurent Brunaud, Phi-Linh Nguyen-Thi, Eric Mirallie, Marco Raffaelli, Menno Vriens, Pierre-Etienne Theveniaud, Myriam Boutami, Brendan M Finnerty, Wessel M C M Vorselaars, Inne Borel Rinkes, Rocco Bellantone, Celestino Lombardi, Thomas Fahey, Rasa Zarnegar, Laurent Bresler
BACKGROUND: Since the 1950s, preoperative medical preparation has been widely applied in patients with pheochromocytoma to improve intraoperative hemodynamic instability and postoperative complications. However, advancements in preoperative imaging, laparoscopic surgical techniques, and anesthesia have considerably improved management in patients with pheochromocytoma. In consequence, there is no validated consensus on current predictive factors for postoperative morbidity. The aim of this study was to determine perioperative factors which are predictive for postoperative morbidity in patients undergoing laparoscopic adrenalectomy for pheochromocytoma...
March 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/25780466/anesthetic-management-for-resection-of-para-aortic-paraganglioma-and-unexpected-aortic-resection-a-case-report
#19
Cheryl Wang, Robert Richmond, Enas Eldesouki
Paragangliomas account for 15-20% of pheochromocytomas derived from chromaffin cells and secretes catecholamines. It has a high mortality rate due to hypertension and challenging anesthetic management. The present report is of a case of the successful management of paraganglioma resection with unexpected aortic resection. The patient presented for paraganglioma resection. The blood pressure (BP) was well controlled with α blockade followed by β blockade prior to surgery. The patient was under general anesthesia, with multiple intravenous lines, catheters and an arterial line...
April 2015: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/25611758/intraoperative-diagnosis-and-treatment-of-thyroid-storm-in-a-15-year-old-male
#20
Bryan Donald Laliberte, Emily Goldenberg, Sarah J Reece-Stremtan
Thyroid storm, a severe complication of hyperthyroidism, can be a devastating medical emergency requiring rapid management. Intraoperative thyrotoxicosis, a hypermetabolic syndrome with increased thyroid hormone levels, also presents a challenging scenario. Clinical suspicion is key along with eliminating other potentially catastrophic emergencies such as malignant hyperthermia or pheochromocytoma. In this case report, we describe a 15-year-old male undergoing halo traction placement for displaced dens and C1 fractures...
October 15, 2014: A & A Case Reports
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