Vitris M, Biouele J M, Binam F, Simeu C, Demaziére J, Saissy J M, Aubert M
Service Anesthésie-Réanimation, Hôpital Principal de Dakar.
Cah Anesthesiol. 1991;39(3):188-90.
Anaesthesia for removal of pheochromocytomas requires preoperative preparation of patients so as to normalize blood pressure. During operation, hypovolemia linked with the sudden fall of circulating catecholamines as well as hypertension during handling of the tumor are to be managed. A case of a 11 year child with pheochromocytoma is reported. Once the diagnosis had been established, various attempts to normalize blood pressure failed. Despite a precarious condition, the operation could be performed. During surgery, hypertension occurred and three hypotensive drugs failed to correct it. It ceased after removal of the tumor. The postoperative course was uneventful. The authors discuss the role of the type of catecholamines and their concentration in the failure of antihypertensive medication.
嗜铬细胞瘤切除手术的麻醉需要对患者进行术前准备,以使血压正常化。手术过程中,要处理与循环儿茶酚胺突然下降相关的低血容量以及肿瘤处理过程中的高血压。本文报道了一例11岁嗜铬细胞瘤患儿病例。确诊后,多次尝试使血压正常化均告失败。尽管病情不稳定,但手术仍得以进行。手术过程中出现了高血压,三种降压药物均未能纠正。肿瘤切除后高血压停止。术后过程顺利。作者讨论了儿茶酚胺类型及其浓度在抗高血压药物治疗失败中的作用。