Watanabe Akiyo, Shimoda Takashi, Takeuchi Muneyuki, Tachibana Kazuya, Kinouchi Keiko
Department of Anesthesia and Intensive Care, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi 594-1101.
Masui. 2010 Mar;59(3):397-400.
We report anesthetic management for a 13-year-old boy undergoing surgical removal of the bilateral adrenal pheochromocytoma. His blood pressure was well-controlled at the time of the operation with an alpha-adrenergic receptor-blocking agent and a calcium channel blocker. His laboratory test, however, showed anemia and prolonged clotting time. Therefore, we preoperatively transfused leukocytes reduced red cells concentrates and fresh frozen plasma. General anesthesia with sevoflurane, propofol, fentanyl combined with thoracic epidural anesthesia was administered. During the surgery, continuous infusion of sodium nitroprusside, and bolus dose of nifedipine and phentolamine were used to control hypertension. Dopamine and noradrenaline were used to prevent the hypotension after the ligation of the adrenal veins. Balanced anesthesia technique provided relatively stable hemodynamics throughout the operation.
我们报告了一名13岁男孩双侧肾上腺嗜铬细胞瘤手术切除的麻醉管理情况。手术时，他的血压通过α-肾上腺素能受体阻滞剂和钙通道阻滞剂得到了良好控制。然而，他的实验室检查显示贫血和凝血时间延长。因此，我们术前输注了去白细胞红细胞浓缩液和新鲜冰冻血浆。采用七氟烷、丙泊酚、芬太尼联合胸段硬膜外麻醉进行全身麻醉。手术期间，持续输注硝普钠，并给予硝苯地平和酚妥拉明推注剂量以控制高血压。使用多巴胺和去甲肾上腺素预防肾上腺静脉结扎后的低血压。平衡麻醉技术在整个手术过程中提供了相对稳定的血流动力学。
