Use of a 'hospital-at-home' service for patient optimization before resection of phaeochromocytoma

The perioperative management of phaeochromocytoma remains a complicated anaesthetic challenge, often requiring a prolonged preoperative hospital stay or numerous outpatient clinic visits. This is not only inconvenient for the patient, it also puts them at additional risk of acquiring hospital infections and is expensive to the health service. We present a patient with a phaeochromocytoma who was successfully managed preoperatively with phenoxybenzamine in the community by a 'hospital-at-home' service. She required no other antihypertensives before operation, although glyceryl trinitrate and magnesium sulphate were used before induction of anaesthesia. Apart from intervention for a chest infection on day 3, she had a relatively smooth hospital course and returned home on day 13. We suggest that this may be an appropriate management option for selected patients.