Vaca AL, Zayas GH, García CMA, Granados MJC

Language: Spanish
References: 17
Page: 27-31
PDF size: 171.09 Kb.

ABSTRACT

Introduction: Neuroendocrine tumors, can be found anywhere on the body. The incidence of pheochromocytoma is 2-8 per million people per year and 10% of these are extra- adrenal tumors. Anesthetic management is considered a challenge for the anesthesiologist, since they are primarily catecholamine secreting tumors, and they must take into account several points for a hemodynamic monitoring of the patient and the multidisciplinary management in the pre, trans and postsurgical period.
Case report: We report the case of a male patient carrier of a bladder para-ganglioma who underwent a surgical resection under general anesthesia and an infusion of isosorbide to control a hypertensive emergency.
Conclusions: We considered, in this particular case, that the use of peripheral vasodilators was beneficial for the treatment of hypertensive emergency during trans- anesthetic.
Discussion: The treatment of hypertensive emergencies reported in the literature shows that the use of intravenous drugs such as sodium nitroprusside, nitroglycerin, labetalol, esmolol, among others, are the most recommended. The use of nitrite is a viable alternative with severe uncontrolled hypertension.

REFERENCES

1. Matos I, Capdevilla J. Tumores Neuroendócrinos. Madrid, España: Sociedad Española de Oncología Médica; abril 2015.

2. Medrano-Guzmán R. Guías de diagnóstico y tratamiento de tumores neuroendocrinos gastroenteropancreáticos. Patología Revista latinoamericana. 2009;47(3):220-8.

3. DeLellis RA, Lloyd RV, Heitz PU, et al., eds. Pathology and Genetics of Tumours of Endocrine Organs. Lyon, France: IARC Press, World Health Organization classification of tumours, vol. 8; 2004.

4. Beard CM, Sheps SG, Kurland LT, et al. Occurrence of pheochromocytoma in Rochester, Minnesota, 1950 through 1979. Mayo Clin Proc. 1983;58(12):802-4,

5. Neumann HP, Bausch B, McWhinney SR, et al. Germline mutations in nonsyndromic pheochromocytoma. N Engl J Med. 2002;346(19):1459-66.

6. Domi r,Sula H, Kaci M, et al. Anesthetic Considerations on Adrenal Gland Surgery. Journal of Clinical Medicine Research. 2015;7(1):1-7.

7. López Correa T, Hernández S, Briz Sánchez E, et al. La anestesia en los paragangliomas cervicocefálicos. Acta Otorrinolaringológica Española. 2009;60 (Supl. 1):76-9.

8. Goutcher CM, Cossar DF, Ratnasabapathy U, et al. Magnesium in the management of catecholamine-secreting glomus tumours with intracranial extension. Can J Anesth. 2006;53:316-21

9. Alamán B, Negrete N, Martín-Romo J, et al. Manejo anestésico de recidiva de paraganglioma mediastínico. Rev Esp Anestesiol Reanim. 2008;55:194- 6.

10. Kinney MAO, Narr BJ, Warner MA. Perioperative management of pheocromocytoma. J Cardiothorac Vasc Anesth. 2002;16:359-69.

11. Roizen MF, Schreider BD, Hassan SZ. Anesthesia for patients with pheochromocytoma. Anesthesiol Clin North Am. 1987;5:269-75.

12. Jiménez C, Cote G, Arnold A, et al. Review: should patients with apparently sporadic pheochromocytomas or paragangliomas be screened for hereditary syndromes? J Clin Endocrinol Metab. 2006;91:2851-8.

13. García Hernández E, González Rodríguez JL, Vega Cruz MS. Cesárea y exéresis de un feocromocitoma bajo anestesia combinada epidural y general. Rev Esp Anestesiol Reanim. 2004;51(4):217-20.

14. Diagnóstico y tratamiento de las crisis hipertensivas en adultos en los tres niveles de atención. México: Secretaría de Salud; 21/marzo/2013.

15. Puente PH, Álvarez JV, Cosmea AÁ, et al. Abordaje diagnóstico y terapéutico de las crisis hipertensivas. Hipertensión y Riesgo Vascular. 2003;20(6):273-82.

16. Sladen R. Perioperative Hypertension: What´s New and What´s Useful? IARS 2002. Review Course Lectures. Supplement to Anesthesia and Analgesia.

17. De la Parte Pérez L. Manejo anestésico de la hipertensión arterial. Rev Cubana Cir. 2003;42(1).