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Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report-
A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated with terazosin, losartan, atenolol and levetiracetam for 2 weeks. Dexmedetomidine was started in the preoperativ...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Anesthesiologists
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531537/ https://www.ncbi.nlm.nih.gov/pubmed/23277819 http://dx.doi.org/10.4097/kjae.2012.63.6.555 |
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author | Jung, Jae-Wook Park, Jung Kyu Jeon, Sang Yoon Kim, Yong Han Nam, So-Hyun Choi, Young-Gyun Bang, Si Ra |
author_facet | Jung, Jae-Wook Park, Jung Kyu Jeon, Sang Yoon Kim, Yong Han Nam, So-Hyun Choi, Young-Gyun Bang, Si Ra |
author_sort | Jung, Jae-Wook |
collection | PubMed |
description | A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated with terazosin, losartan, atenolol and levetiracetam for 2 weeks. Dexmedetomidine was started in the preoperative waiting area, and a combination of dexmedetomidine and remifentanil was continuously infused for most of anesthetic time. To control blood pressure, bolus injection of remifentanil and low-dose infusion of sodium nitroprusside, nicardipine, and esmolol were administered during three adrenergic crises. There was minimal post-resection hypotension, and his trachea was extubated safely 20 min after the surgery. He was discharged without noticeable complication. His catecholamine levels showed the steadily decreasing pattern during the operation in this case. Though a combination of dexmedetomidine and remifentanil may not prevent the hemodynamic instability impeccably during the tumor manipulation, this combination seems to be the way of interrupting release of catecholamines and minimizing hemodynamic fluctuations. |
format | Online Article Text |
id | pubmed-3531537 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | The Korean Society of Anesthesiologists |
record_format | MEDLINE/PubMed |
spelling | pubmed-35315372012-12-31 Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- Jung, Jae-Wook Park, Jung Kyu Jeon, Sang Yoon Kim, Yong Han Nam, So-Hyun Choi, Young-Gyun Bang, Si Ra Korean J Anesthesiol Case Report A 15-year-old adolescent with unilateral multiple adrenal pheochromocytoma had an episode of subcortical intracerebral hemorrhage and seizure 6 weeks before the surgery. He was pretreated with terazosin, losartan, atenolol and levetiracetam for 2 weeks. Dexmedetomidine was started in the preoperative waiting area, and a combination of dexmedetomidine and remifentanil was continuously infused for most of anesthetic time. To control blood pressure, bolus injection of remifentanil and low-dose infusion of sodium nitroprusside, nicardipine, and esmolol were administered during three adrenergic crises. There was minimal post-resection hypotension, and his trachea was extubated safely 20 min after the surgery. He was discharged without noticeable complication. His catecholamine levels showed the steadily decreasing pattern during the operation in this case. Though a combination of dexmedetomidine and remifentanil may not prevent the hemodynamic instability impeccably during the tumor manipulation, this combination seems to be the way of interrupting release of catecholamines and minimizing hemodynamic fluctuations. The Korean Society of Anesthesiologists 2012-12 2012-12-14 /pmc/articles/PMC3531537/ /pubmed/23277819 http://dx.doi.org/10.4097/kjae.2012.63.6.555 Text en Copyright © the Korean Society of Anesthesiologists, 2012 http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Jung, Jae-Wook Park, Jung Kyu Jeon, Sang Yoon Kim, Yong Han Nam, So-Hyun Choi, Young-Gyun Bang, Si Ra Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- |
title | Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- |
title_full | Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- |
title_fullStr | Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- |
title_full_unstemmed | Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- |
title_short | Dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -A case report- |
title_sort | dexmedetomidine and remifentanil in the perioperative management of an adolescent undergoing resection of pheochromocytoma -a case report- |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531537/ https://www.ncbi.nlm.nih.gov/pubmed/23277819 http://dx.doi.org/10.4097/kjae.2012.63.6.555 |
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