Guo Xiang-yang, Luo Ai-lun, Gong Zhi-yi, Ren Hong-zhi, Yie Tie-hu, Huang Yu-guang
Department of Anaesthesia, PUMC Hospital, CAMS, PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2002 Aug;24(4):424-6.
To summarize experience of perioperative anesthetic management for patients undergone excision of pheochromocytoma and complicated with catecholamine cardiomyopathy.
Perioperative anesthetic management for surgical treatment of three cases of pheochromocytoma complicated with catecholamine cardiomyopathy was described and discussed according to literature reports.
The catecholamine cardiomyopathy of the three cases presented with left ventricular hypertrophy, congestive cardiac failure and acute myocardial infarction. After removal of the pheochromocytoma under general anesthesia, a prolonged hypotension occurred in all of the three cases. In order to maintain stable hemodynamics, large dose of catecholamine was required after surgery. All of the three patients were survived and discharged.
It is suggested that myocardial dysfunction may be another important factor for the prolonged hypotension after removal of the tumor. Meticulous preoperative assessment of heart function is of primary importance for the management of anaesthesia during surgical procedures.
总结嗜铬细胞瘤切除合并儿茶酚胺心肌病患者围手术期麻醉管理经验。
根据文献报道，描述并讨论3例嗜铬细胞瘤合并儿茶酚胺心肌病患者手术治疗的围手术期麻醉管理。
3例儿茶酚胺心肌病均表现为左心室肥厚、充血性心力衰竭和急性心肌梗死。全身麻醉下切除嗜铬细胞瘤后，3例均出现长时间低血压。为维持血流动力学稳定，术后需使用大剂量儿茶酚胺。3例患者均存活并出院。
提示心肌功能障碍可能是肿瘤切除后长时间低血压的另一个重要因素。术前仔细评估心功能对手术过程中的麻醉管理至关重要。
