ANAESTHESIA FOR LAPAROSCOPIC EXCISION OF PHEOCHROMOCYTOMA AND PARAGANGLIOMAS IN PAEDIATRIC POPULATION- OUR INSTITUTIONAL EXPERIENCE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 93
Abstract
Pheochromocytoma presents a challenge to the anaesthesiologists because of its clinical features and implications, especially in paediatric population. The most crucial moments are induction and haemodynamic oscillations. Our review aims at discussion of pharmacological strategies regarding perioperative management of paediatric pheochromocytoma in our institution. The objective of this study is to look for various strategies aiding in better perioperative anaesthetic care of pheochromocytoma patients in future. MATERIALS AND METHODS We managed 7 children aged between 8 and 14 years with pheochromocytoma over a period of 9 years from 2006 to 2015. Hypertension, headache and sweating were the most common clinical features noted. Early involvement of anaesthesiologist in preoperative management was achieved with phenoxybenzamine in all the patients. Main anaesthetic drugs used were thiopental sodium, morphine, atracurium, dexmedetomidine and magnesium sulphate. RESULTS There was successful perioperative management of all children. Two of the seven patients underwent intraoperative conversion of surgery to open laparotomy, two had severe post-operative hypotension which was well managed on time and recurrence of pheochromocytoma was seen in one patient. All children were normotensive when discharged. There were no deaths reported on long-term followup. CONCLUSION Adequate preoperative preparation, modern anaesthetic drugs, good collaboration with surgeons and proper post-operative care can improve the outcome and complications.
Authors and Affiliations
Kunigal Ravishankar Chandrakala, Dammaningala Venkataramaiah Bhagya, Yabagodu Ramayya Chandrika
Keywords
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- EP ID EP279587
- DOI 10.14260/jemds/2017/1466
- Views 87
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