ACUTE HYPERTENSION DURING ANESTHESIA-THE UNSUSPECTED PHEOCHROMOCYTOMA

Abstract

The existence of a pheochromocytoma was found to explain hypertensive episodes which occurred during anesthesia in two patients. In one, a 25-year-old man, the first two episodes occurred during an attempt to excise an intracranial tumor. At a subsequent operation this tumor was completely removed, but attempts to remove the primary retroperitoneal tumor were unsuccessful because it had invaded surrounding structures. In the other patient, a 51-year-old man, a sudden rise of systolic blood pressure to 620 mm. Hg occurred during a lumbar sympathectomy. The suspicion of pheochromocytoma was verified when autopsy revealed a tumor in the left adrenal gland which weighed 1.4 kg. Sudden hypertension during surgical anesthesia should be treated with the urgency associated with cardiac arrest. In one case it responded promptly to administration of phentolamine. The possibility that a pheochromocytoma may be present should then be investigated.