Bajwa Sukhminderjit Singh, Bajwa Sukhwinder Kaur
Department of Anaesthesiology and Intensive Care, GianSagar Medical College and Hospital, Banur, Punjab, India.
Indian J Endocrinol Metab. 2011 Oct;15 Suppl 4(Suppl4):S337-44. doi: 10.4103/2230-8210.86977.
Pheochromocytoma is a rare catecholamine secreting tumor arising commonly from adrenal medulla. It has got multidimensional challenging aspects in spite of our improved understanding of its physiological and clinical behavior during surgical resection. This neuroendocrine tumor is associated with a most unpredictable and fluctuating clinical course during anesthesia and surgical intervention. The clinical difficulties and challenges increase manifold in patients with undiagnosed or accidental diagnosis of pheochromocytoma who present to the hospital for the treatment of some other disease or emergency. The most common manifestations of this clinical spectrum include hypertension, headache, palpitations, episodic sweating, and feeling of doom. The definite and only treatment for this rare tumor is surgical resection which itself is very challenging for an anesthesiologist. This article reviews the pre-operative evaluation, pharmacological preparation, intraoperative and post-operative management of patients with pheochromocytoma especially from anesthesiologist's perspectives.
嗜铬细胞瘤是一种罕见的分泌儿茶酚胺的肿瘤，通常起源于肾上腺髓质。尽管我们对其在手术切除过程中的生理和临床行为有了更好的理解，但它仍存在多方面具有挑战性的问题。这种神经内分泌肿瘤在麻醉和手术干预期间具有极其不可预测且波动的临床过程。对于因其他疾病或急诊到医院就诊而未被诊断或意外诊断为嗜铬细胞瘤的患者，临床困难和挑战会成倍增加。这一临床谱最常见的表现包括高血压、头痛、心悸、阵发性出汗和濒死感。这种罕见肿瘤明确且唯一的治疗方法是手术切除，而这本身对麻醉医生来说极具挑战性。本文尤其从麻醉医生的角度综述了嗜铬细胞瘤患者的术前评估、药物准备、术中和术后管理。
