WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*PR. Dr. Faten Rostom and Dr. Ayham Khddam

ABSTRACT

Background and Objective: Pheochromocytoma is a rare neoplasm usually arising from the chromaffin cells of the adrenal medulla or from other chromaffin tissues outside the adrenal gland, which results in releasing of huge amounts of catecholamines causes a hypertensive crisis that may occur during pheochromocytoma resection. Controlling these seizures is the goal of this research. Research materials and methods: Remifentanil, Sodium Nitroprusside, Sevoflurane, and Dexmedetomidine were used as pharmacological adjuncts to achieve good hemodynamic stability in a 5 years old boy who went under adrenal gland resection. Intraoperative pressure attacks were managed by raising sevoflurane values to 6% and increasing the dose of sodium nitroprusside from 1-2-4 mcg/kg/min. During the period between tumor intervention and adrenalectomy we increased the dose of remifentanil infusion within the safe range to 1.3 mcg/kg/min and increased the dose of Dexmedetomidine “which is the strongest synergistic of sevoflurane” to 0.7 mg/kg/h to ensure stabilization of pressure and pulse and to control pressure attacks. Results: Using these elements allowed us to maintain hemodynamic stability during pheochromocytoma resection and prevent a life-threatening crisis. Conclusion: This combination appears to be a successful way to suppress the release of catecholamines and reduce circulatory fluctuations.

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