Update in perioperative anesthetic management of pheochromocytoma

Table 1 Drugs commonly used in preoperative preparation of pheochromocytoma

Drug name	Dosages	Additional information
Phenoxybenzamine	60-50 mg	Dizziness, headache, nasal stuffiness peripheral edema and prolonged hypotension (long postoperative blockade)
Doxazosin	2-6 mg	Short acting, no prolonged hypotension
Beta blockers
Propranolol	80-120 mg	Careful in patients with asthma, conduction disturbances, severe heart failure. May cause severe bradycardia and postural hypotension
Metoprolol	50-100 mg
Labetalol	5-10 mg q5 min
Calcium channel blockers
Verapamil	120-240 mg	Careful in patients with n AV blocks, hypovolemia, sinus sick syndrome, and heart failure
Diltiazem	180 mg
Nifedipine	30-90 mg	Side effects: Elevated liver enzymes, headache, constipation, dizziness, fatigue, edema
Clonidine	0.1-1.2 mg
Dexmedetomidine	1 mg/kg in 10 min, 0.7 mg/kg per hour infusion	Dizziness, rebound hypertension side effects: depression, anxiety, dry mouth, bradycardia
Magnesium sulfate	1-8 mg loading dose, 1-4 mg/h maint	Potentiates neuromuscular blockade, caution in heart block and renal failure
Urapidil	10-15 mg/h	Caution because of severe hypotension
Alpha methyl-p-tyrosine	1-4 g/d	Crystaluria, extra-pyramidal and psychic disturbances