Combined general and epidural anaesthesia for excision of phaeochromocytoma--a unique and safe technique

Surgical excision of phaeochromocytoma is usually associated with elevation of arterial blood pressure above 200 mmHg for some time irrespective of the use or not of preoperative alpha-adrenergic blockade. Attempts at controlling the elevated blood pressure usually involve the use of many drugs through induction, maintenance, termination and post operative period. We recently used a combined general and epidural anaesthesia for excision of a huge phaeochromocytoma in a 24 yr old Nigerian lady with a satisfactory outcome. The combined technique seemed to have modified the anaesthetic course considerably, resulting in the use of fewer drugs and a steady haemodynamic state which is very unusual in anaesthesising patients with phaeochromocytoma (see haemodynamic record Illustration II). Post-operative analgesia was provided with morphine given through the epidural catheter.