[Behavior of hemodynamics and catecholamines in patients undergoing excision of pheochromocytoma]

In order to investigate the relation between catecholamine output and haemodynamics, 13 patients aged between 16 and 62 years, who were operated for active pheochromocytoma, were investigated. Patients had general anesthesia employing muscle relaxants, artificial ventilation with nitrous oxide/oxygen and predominantly intravenous analgetics. Before surgery 9 patients had increased norepinephrine blood levels and only 6 patients increased epinephrine levels. Intraoperatively an increase in pulse rate and blood pressure was found, although alpha- and beta-blockers were employed. At this time there was a massively increased level of epinephrine and norepinephrine, both however decreasing at the conclusion of surgery going along with a normalisation of cardial parameters. Comparing norepinephrine to cardiovascular parameters, the best correlation could be found between norepinephrine and mean arterial pressure, followed by total catecholamines and mean arterial pressure. Heart rate showed a smaller correlation coefficient to norepinephrine, followed by norepinephrine and total peripheral resistance. It is concluded that invasive haemodynamic monitoring helps to differentiate between haemodynamic disturbances and to improve the cardiovascular management, although direct relations between blood catecholamine levels and circular vascular parameters could not be found.