[Cesarean delivery and exeresis of a pheochromocytoma performed under epidural and general anesthesia]

A 33-year-old pregnant woman with episodes of nocturnal tachycardia and anxiety diagnosed with extra-renal pheochromocytoma in her 28th month of gestation was admitted in her 38th week for an alpha-adrenergic block prior to elective cesarean section and tumor exeresis. The cesarean section was performed with the patient given an epidural lumbar block, and immediately after delivery of the fetus total intravenous anesthesia (with propofol, remifentanil, and rocuronium) was administered in addition to the continuous epidural analgesia used during tumor resection and postoperatively. No complications developed during surgery or recovery and the clinical courses were satisfactory for both mother and child. The use of propofol and remifentanil in combination with epidural anesthesia is not common in our clinical context. We point out that the multimodal technique affords good hemodynamic stability, guarantees satisfactory analgesia, and reduces the need for vasoactive drugs.