[Anesthetic management for a child with bilateral pheochromocytoma]

We report anesthetic management for a 13-year-old boy undergoing surgical removal of the bilateral adrenal pheochromocytoma. His blood pressure was well-controlled at the time of the operation with an alpha-adrenergic receptor-blocking agent and a calcium channel blocker. His laboratory test, however, showed anemia and prolonged clotting time. Therefore, we preoperatively transfused leukocytes reduced red cells concentrates and fresh frozen plasma. General anesthesia with sevoflurane, propofol, fentanyl combined with thoracic epidural anesthesia was administered. During the surgery, continuous infusion of sodium nitroprusside, and bolus dose of nifedipine and phentolamine were used to control hypertension. Dopamine and noradrenaline were used to prevent the hypotension after the ligation of the adrenal veins. Balanced anesthesia technique provided relatively stable hemodynamics throughout the operation.