Pheochromocytoma
nilesh tatar
Today I and Hitendra did c/o pheochromocytom. 44yr. old with adrenal
mass normotensive in wards ,VMA- 13.2 (HIGHER NORMAL VALUE 13.6) rest
investigations WNL. At the time of induction B.P. was 160/105 . SNP
started. arterial line and jugular line taken.Induced with profofol,
scolin , intubation and vec. Maint.- O2,nitrous and isoflurane. SNP
started from induction .B.P. was in thrange of around 110 ,120
systolic and when surgeon touched the tumor B.P. Went around 230,
systolic, SNP drops raised and labetalol around 7.5 mg bolus given.
B.P.considarably dropped down within normal limits . At the time of
clamping vain B.P.dropped to max. 70 systolic.which was managed with
dopamin. surgery lasted for only 1 to 1and 1/2 hr.
vibha naik
I wanted to know if you encountered any arrythmias? short bursts of SVTs and ectopics are common during handling of the tumor.
Here is the article i was mentioning -
http://medind.nic.in/iad/t05/i2/iadt05i2p137.pdf
this is by rajiv (you met him in chennai) while in nims. here sevoflurane has been solely used to handle fluctuations in bp without any ectopics - usually due to sensitization of the myocardium with the inhalational agents.
if you came across any other special article or any specific point about pheo, pls do post.
Congratulations again.
Consultant Anesthesiologist,
Smile Train Project,
Nizams Institute of Medical Sciences,
Hyderabad, India.
E-mail: vib...@yahoo.co.in
Mobile: +91 9959189958
From: nilesh tatar <niles...@gmail.com>
To: ISA NASHIK <isan...@googlegroups.com>
Sent: Mon, 18 January, 2010 1:52:17 PM
Subject: Pheochromocytoma
nilesh tatar
We didn't encounter any sort of arrythmias which is expected. Even
when i did last case of pheo around 6mths back which was a unprepared
case even i was not prepared for the crisis and B.P. started rising
upto 270 and nonrecordable on my monitor; There was an acute st
depression in lead II which i was monitoring but no arrythmias . This
B.P. remained high for about 20- 30 min.but god was with me and no
postop complication. This case definitely taught me how lack of
prepartion even for benign adrenal mass can tear you.
On Jan 20, 6:09 pm, vibha naik <vibn...@yahoo.co.in> wrote:
> Hi guys, good job!
>
> I wanted to know if you encountered any arrythmias? short bursts of SVTs and ectopics are common during handling of the tumor.
>
> Here is the article i was mentioning -http://medind.nic.in/iad/t05/i2/iadt05i2p137.pdf
> this is by rajiv (you met him in chennai) while in nims. here sevoflurane has been solely used to handle fluctuations in bp without any ectopics - usually due to sensitization of the myocardium with the inhalational agents.
>
> if you came across any other special article or any specific point about pheo, pls do post.
>
> Congratulations again.
>
> Dr Vibhavari Naik, MD
> Consultant Anesthesiologist,
> Smile Train Project,
> Nizams Institute of Medical Sciences,
> Hyderabad, India.
> E-mail: vibn...@yahoo.co.in
> Mobile: +91 9959189958
>
> ________________________________
> From: nilesh tatar <nileshta...@gmail.com>
> To: ISA NASHIK <isan...@googlegroups.com>
> Sent: Mon, 18 January, 2010 1:52:17 PM
> Subject: Pheochromocytoma
>
> Dear all,
> Today I and Hitendra did c/o pheochromocytom. 44yr. old with adrenal
> mass normotensive in wards ,VMA- 13.2 (HIGHER NORMAL VALUE 13.6) rest
> investigations WNL. At the time of induction B.P. was 160/105 . SNP
> started. arterial line and jugular line taken.Induced with profofol,
> scolin , intubation and vec. Maint.- O2,nitrous and isoflurane. SNP
> started from induction .B.P. was in thrange of around 110 ,120
> systolic and when surgeon touched the tumor B.P. Went around 230,
> systolic, SNP drops raised and labetalol around 7.5 mg bolus given.
> B.P.considarably dropped down within normal limits . At the time of
> clamping vain B.P.dropped to max. 70 systolic.which was managed with
> dopamin. surgery lasted for only 1 to 1and 1/2 hr.
>
> The INTERNET now has a personality. YOURS! See your Yahoo! Homepage.http://in.yahoo.com/