[Anesthesia for the surgery of malignant pheochromocytoma. Hypertensive crisis after the administration of droperidol].

A case of malignant phaeochromocytoma is reported. Computerized tomography and scintigraphy using metaiodobenzylguanidine localized the tumour and metastases. The anesthetic management included invasive monitoring of pulmonary pressures with a Swan-Ganz catheter and arterial pressure with a radial arterial cannula. Plasma catecholamine concentrations were measured before and during adrenalectomy and resection of a metastatic lesion on the fourth right rib. Induction of anaesthesia was carried out with droperidol, phenoperidine, thiopentone and pancuronium. After intravenous administration of droperidol, blood pressure increased together with the heart rate, vascular resistances and pulmonary pressure, whilst cardiac output decreased. Plasma noradrenaline levels were also greatly increased at the same time. The mechanism of this paradoxic pressor effect of droperidol is discussed.