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Midazolam-sufentanil anaesthesia for phaeochromocytoma resection
J D Shapiro1, A el-Ganzouri, P F White
1Department of Anesthesiology, Rush Presbyterian St. Luke's Medical Center, Chicago, Illinois 60612.
Abstract:
This is a case report of a 66-year-old patient to whom a combined infusion of midazolam and sufentanil was administered for phaeochromocytoma resection. With the exception of a drop in blood pressure immediately after tumour removal, significant intraoperative haemodynamic stability was observed. There was no need for the intraoperative administration of hypotensive or anti-arrhythmic drugs, nor was any prolonged postoperative anaesthetic effect noted. In this case, the combination of midazolam and sufentanil with N2O:O2 was successful in maintaining cardiovascular stability until the tumour was removed. The consequent drop in blood pressure responded to fluid infusion, a not uncommon event in phaeochromocytoma surgery. Although a prospective randomized study for resection of phaeochromocytoma showed that the choice of the anaesthetic technique is not a crucial factor in determining the patient outcome, we feel this technique of midazolam sufentanil is a worthy alternative to the use of inhalational anaesthetics. The lack of significant myocardial depressive effect of the two drugs, coupled with its simple administration, makes it a useful technique in the anaesthetic management of phaeochromocytoma resection.