Jeong Cheol Won, Lee Hyung Gon, Kim Woong Mo, Shin Seung Heon, Bae Hong Beom
Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School, Gwangju, Korea.
Korean J Anesthesiol. 2009 Aug;57(2):249-253. doi: 10.4097/kjae.2009.57.2.249.
Pheochromocytoma is an uncommon tumor that originates in the adrenal medulla or in other paraganglia of the sympathetic nervous system. If a hypertensive crisis occurs during general anesthesia in incidental or untreated pheochromocytoma, it is a life-threatening event with a mortality rate of about 80%. Anesthetic drugs such as pancuronium, atracurium, and metoclopromide can exacerbate the potentially lethal cardiovascular effects of catecholamines. We report a case of a patient with pheochromocytoma who display abrupt increases in systolic arterial pressure and plasma norepinephrine following rocuronium administration. This case indicates the possible involvement of elevated sympathetic nervous system to a catecholamine crisis triggered by rocuronium in pheochromocytoma.
嗜铬细胞瘤是一种罕见的肿瘤，起源于肾上腺髓质或交感神经系统的其他副神经节。如果在偶然发现或未经治疗的嗜铬细胞瘤患者全身麻醉期间发生高血压危象，这是一个危及生命的事件，死亡率约为80%。泮库溴铵、阿曲库铵和甲氧氯普胺等麻醉药物可加重儿茶酚胺潜在的致命心血管效应。我们报告一例嗜铬细胞瘤患者，在给予罗库溴铵后出现收缩压和血浆去甲肾上腺素突然升高。该病例表明，嗜铬细胞瘤患者交感神经系统兴奋可能参与罗库溴铵引发的儿茶酚胺危象。
