Ozer Ayse Belin, Demirel Ismail, Duzgol Ozgur, Ayten Refik, Erhan Omer Lutfi
Department of Anesthesiology and Reanimation, Faculty of Medicine, Firat University, Elazig 23119, Turkey.
Department of General Surgery, Faculty of Medicine, Firat University, Elazig 23119, Turkey.
Saudi J Anaesth. 2014 Nov;8(Suppl 1):S105-8. doi: 10.4103/1658-354X.144088.
An operation was planned for a female patient aged 59 for intra-abdominal mass. The patient was using nebivolol for hypertension. Blood pressure (BP) of the patient was raised to 200/130 mmHg during anesthesia induction. BP was gradually reduced by remifentanil infusion. Following the manipulation of the mass, BP began to increase (225/160 mmHg), thus nitroglycerin and followed nitroprusside infusion was started. Propofol (200 + 200 mg) and furosemide (20 mg) were administered intravenously. BP suddenly dropped (90/60 mmHg) following the removal of the mass, nitroglycerine, and nitroprusside infusions were stopped; remifentanil dose was decreased and fluid was quickly infused. The patient was uneventually recovered. Vanilmandelic acid level was higher in the patient and pheochromocytoma was considered.
计划为一名59岁的女性患者进行腹腔内肿块手术。该患者正在使用奈必洛尔治疗高血压。麻醉诱导期间患者血压升至200/130 mmHg。通过输注瑞芬太尼使血压逐渐降低。在对肿块进行操作后，血压开始升高（225/160 mmHg），于是开始输注硝酸甘油，随后又开始输注硝普钠。静脉注射丙泊酚（200 + 200 mg）和呋塞米（20 mg）。在切除肿块后血压突然下降（90/60 mmHg），停止输注硝酸甘油和硝普钠；减少瑞芬太尼剂量并快速输注液体。患者最终康复。患者香草扁桃酸水平较高，考虑为嗜铬细胞瘤。
