[Clinical management of hypertension in patients with pheochromocytoma]

Surgical treatment of 18 tumors in 17 patients with pheochromocytoma, containing unsynchronous bilateral adrenal tumors, was performed at our department between 1978 and 1995. As an index of management of hypertension before and after surgery, maximum systolic blood pressure except critical region (more than mean + 2 SD) was used in this study. As an index of control of blood pressure during surgery, the difference between maximum and minimum systolic blood pressure during palpating tumor was also adopted. The index before surgery was closely correlated with the index in surgery (R = 0.646, P = 0.0038); maximum systolic blood pressure before surgery was a useful index forecasting the variation of blood pressure in surgery. The management of blood pressure before surgery was the most difficult in the group with sustained hypertension with superimposed paroxysms. After surgery, 2 patients without hypertension before surgery had hypotension, 2 others remained hypertensive and the others had normal blood pressure. Our findings indicated that the index of management of hypertension before surgery used in this study was a simple, noninvasive and important marker for variation of blood pressure in surgery.