Introduction: Patients posted for adrenalectomy with pheochromocytoma pose major
challenge to anaesthesiologist as there may be excess catecholamine release during its removal
that leads to severe hypertension and arrythmias intra operatively.
Case presentation: Here we discuss anaesthetic management of 27 year old female with right
supra renal mass posted for right adrenalectomy. She came with complaints of abdominal pain
and weight gain for which hormonal evaluation and CECT abdomen done and was diagnosed
with pheochromocytoma of right adrenal gland. As patient was obese and venous accesibility
was difficult central venous catheterisation was done prior to surgery. Case was done under
combined epidural with general anaesthesia.
Conclusion: In patients with pheochromocytoma posted for adrenalectomy, pre operative
hormonal evaluation, intra operative and post operative hemodynamic stability are important.
Intra operative and post operative tachycardia, hypertension prevented by smooth induction,
minimise the intubation and extubation response and use of other adrenergic blockade drugs
during and after surgery. Effective post operative pain management is necessary.
: Manjula Devi S1