Gupta A, Garg R, Gupta N. Update in perioperative anesthetic management of pheochromocytoma. World J Anesthesiol 2015; 4(3): 83-90 [DOI: 10.5313/wja.v4.i3.83]
Corresponding Author of This Article
Dr. Rakesh Garg, Assistant Professor, Department of Anesthesiology, Pain and Palliative Care, Dr BRAIRCH, All India Institute of Medical Sciences, Room No. 139, Ist Floor, Ansari Nagar, New Delhi 110029, India. drrgarg@hotmail.com
Research Domain of This Article
Anesthesiology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Anesthesiol. Nov 27, 2015; 4(3): 83-90 Published online Nov 27, 2015. doi: 10.5313/wja.v4.i3.83
Update in perioperative anesthetic management of pheochromocytoma
Anju Gupta, Rakesh Garg, Nishkarsh Gupta
Anju Gupta, Department of Anesthesiology, LokNayak Hospital, New Delhi 110002, India
Rakesh Garg, Nishkarsh Gupta, Department of Anesthesiology, Pain and Palliative Care, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: All authors had participated drafting the article and making critical revisions related to important intellectual content of the manuscript, and final approval of the version of the article to be published.
Conflict-of-interest statement: None of the authors have any commercial, personal, political, intellectual, or religious interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Rakesh Garg, Assistant Professor, Department of Anesthesiology, Pain and Palliative Care, Dr BRAIRCH, All India Institute of Medical Sciences, Room No. 139, Ist Floor, Ansari Nagar, New Delhi 110029, India. drrgarg@hotmail.com
Telephone: +91-98-10394950
Received: April 27, 2015 Peer-review started: May 7, 2015 First decision: June 4, 2015 Revised: August 23, 2015 Accepted: September 25, 2015 Article in press: September 28, 2015 Published online: November 27, 2015 Processing time: 211 Days and 23.1 Hours
Abstract
Pheochromocytoma is a tumor that originates from either chromaffincells in adrenal medulla or in other paraganglia tissues of the sympathetic nervous system. The perioperative management is quite challenging especially in view of hemodynamic fluctuations. Pheochromocytoma is challenging in view of the impact of excessive and depleted catecholamines in the perioperative period. It requires a through preoperative evaluation and optimization with meticulous intraoperative management. The postoperative period requires vigilance to prevent any untoward complication. In this review we review these concepts based on recent evidence for an optimal outcome.
Core tip: The paper is a comprehensive review of the most important pathophysiological and diagnostic issues, preoperative optimization, and anesthesia management of pheochromocytoma. It describes advanced imaging and biochemical techniques for diagnosis and localisation. Once considered nightmare by anaesthesiologist, pheochromocytoma have improved outcome nowadays due to widely available vasoactive drugs, monitors and perioperative care. Also, availability of laparoscopic and robotic adrenal-sparing adrenalectomy has reduced hospital stay and hastened recovery.
