Matsuura T, Kashimoto S, Okuyama K, Oguchi T, Kumazawa T
Department of Anesthesiology, Yamanasi Central Hospital, Kofu.
Masui. 1995 Oct;44(10):1388-90.
A 45-year-old female was scheduled for left adrenalectomy because of a pheochromocytoma. Preoperative general condition was well controlled with alpha- and beta-blockers. Anesthesia was induced with thiamylal and vecuronium, and maintained with isoflurane (0.5-3%) and nitrous oxide in oxygen. Blood pressure was controlled with nicardipine and alpha-blocker during the manipulation of the tumor. After removal of the tumor, dopamine and norepinephrine were used. We used transesophageal echocardiography (TEE) to determine the fluid administration rate and doses of catecholamine. We could observe the wall motion and the mass of the heart, and see changes of the left ventricular enddiastolic volume, the cardiac output and the stroke volume. TEE monitoring seems to be very useful during the resection of pheochromocytoma.
一名45岁女性因嗜铬细胞瘤计划行左肾上腺切除术。术前一般情况通过α和β受体阻滞剂得到良好控制。麻醉诱导采用硫喷妥钠和维库溴铵，维持采用异氟烷（0.5 - 3%）和氧化亚氮-氧气混合气。在肿瘤操作过程中，血压用尼卡地平及α受体阻滞剂控制。肿瘤切除后，使用了多巴胺和去甲肾上腺素。我们采用经食管超声心动图（TEE）来确定液体输注速率及儿茶酚胺剂量。我们能够观察到心脏壁运动及心脏质量，以及左心室舒张末期容积、心输出量和每搏输出量的变化。TEE监测在嗜铬细胞瘤切除术中似乎非常有用。
