[Anesthesia for a patient with pheochromocytoma associated with chronic renal failure]

A case of a 53-year-old man with left pheochromocytoma associated with chronic renal failure is described. He had been on regular hemodialysis for 15 years. Also, because of right renal carcinoma, he underwent right nephrectomy at the same time. For preoperative preparation, we kept the patient's dry weight. Anesthesia was induced with isoflurane 1.0% in oxygen, and fentanyl 0.3 mg and midazolam 5 mg, followed by tracheal intubation facilitated with vecuronium. Anesthesia was maintained with isoflurane 0.5% in oxygen 50-100%, fentanyl and midazolam. Intraoperative hypertension during the manipulation of the tumor and hypotension after removal of the tumor were controlled by continuous or bolus infusion of phentolamine and norepinephrine respectively. For intraoperative fluid management, we administered crystalloid solution 4 ml.kg-1.hr-1. Careful preoperative management was carried out to prevent severe intraoperative and postoperative cardiovascular or respiratory complications.