Successful Management of Phaeochromocytoma using Preoperative Oral Labetalol and Intraoperative Magnesium Sulphate Report of four cases
Journal Title: Sultan Qaboos University Medical Journal - Year 2014, Vol 14, Issue 2
Abstract
Phaeochromocytoma is a rare neuroendocrine catecholamine-secreting tumour. Tis type of tumour poses multidimensional anaesthetic challenges as it has an unpredictable clinical course during surgical resection. Te alpha-blocking agent phenoxybenzamine remained the mainstay in preoperative preparation before the introduction of beta-blocking agents. We report four cases operated between 2009–2012 at Sultan Qaboos University Hospital, Muscat, Oman. Te cases were prepared with oral labetalol, as the alpha-blocking drug phenoxybenzamine was not immediately available. Responses to simulated stress were tested in the theatre before surgery. Anaesthesia was induced under invasive arterial pressure monitoring and magnesium sulphate infusion. Rare intraoperative surges in blood pressure during tumour manipulation were treated with sodium nitroprusside infusions and phentolamine boluses. All of the patients had an uneventful postoperative recovery. Preoperative treatment with labetalol has rarely been reported and can be considered as a potential therapeutic option with optimal patient monitoring if phenoxybenzamine is unavailable.
Authors and Affiliations
Sanath Kumar B. S. | Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital, Rohit Date| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital, Nicholas Woodhouse| Department of Medicine, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Omayma El-Shafe| Departments of Medicine, Sultan Qaboos University Hospital, Karin Nollain| Departments of Anaesthesia & Intensive Care, Sultan Qaboos University Hospital
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