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Abstract:
The occurrence of hypertensive crises, arrhythmias and hypotensive crises during surgery for pheochromocytoma can be prevented both preoperatively and intraoperatively by adequate alpha-adrenergic blockade and volume replacement. Only in a few cases is additional beta-adrenergic blockade necessary. Preoperatively the author uses phenoxybenzamine (Dibenicyline) as alpha-blockade in a dose of 20-30 mg daily, and propanolol (Inderal) as beta-blockade in a dose of 4 X 20 mg daily, both given orally. Intraoperatively he gives preference to alpha-adrenergic receptor blockers with a short halflife, i.e. phentolamine (Regitin) and lidocaine or pranolol as the beta-adrenergic blocker.