Catecholamine Excess
Thu, 12/27/2007 - 00:46 — oxygen
Catecholamine Excess
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clinical causes
clinical manifestations
anesthetic management
Clinical cause:
ex. Pheochromocytoma (catecholamine secreting tumor)
Clinical manifestations:
-headache paroxysmal
-hypertension
-sweating
-palpitations
Anesthetic management:
Preoperative management:
-alpha adrenergic blockade
-volume replacement
-evaluate blood pressure (resting blood pressure and orthostatic responsiveness)
-evaluate heart rate
-evaluate for ventricular ectopy
-evaluate for ecg changes
Intraoperative management:
Induction/intubation:
-should provide deep level of anesthesia prior to intubation
Intraoperative hypertension generally treated with:
-phentolamine
-nitroprusside
-nicardipine
After ligation of the adrenal tumor:
-may experience hypotension
-treat with fluids
-may try treating with phenylephrine and norepinephrine
clinical causes
clinical manifestations
anesthetic management
Clinical cause:
ex. Pheochromocytoma (catecholamine secreting tumor)
Clinical manifestations:
-headache paroxysmal
-hypertension
-sweating
-palpitations
Anesthetic management:
Preoperative management:
-alpha adrenergic blockade
-volume replacement
-evaluate blood pressure (resting blood pressure and orthostatic responsiveness)
-evaluate heart rate
-evaluate for ventricular ectopy
-evaluate for ecg changes
Intraoperative management:
Induction/intubation:
-should provide deep level of anesthesia prior to intubation
Intraoperative hypertension generally treated with:
-phentolamine
-nitroprusside
-nicardipine
After ligation of the adrenal tumor:
-may experience hypotension
-treat with fluids
-may try treating with phenylephrine and norepinephrine
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