Catecholamine Excess

Listen to Audio

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