Emergency Anesthesia in a Patient with von Hippel-Lindau Syndrome Who Underwent Pheochromocytectomy and the Resection of Cerebellar Hemangioblastoma

Abstract

  We present an anesthesia case of a 37-year-old male patient with von Hippel-Lindau syndrome who was complicated with uncontrolled pheochromocytoma and cerebellar hemangioblastoma. On the fifth day after admission, because the patient showed clinical signs of high intracranial pressure, emergency surgery was decided. First, under general anesthesia, pheochromocytectomy was performed and then hemangioblastoma were removed on the same day. We initially were able to successfully control the patient's blood pressure with high dose remifentanil (1.0 μg/kg/min) and vasodilators. Following pheochromocytectomy, we lowered the dose of remifentanil (0.2-0.3 μg/kg/min) and the patient's blood pressure was able to be maintained in the normal range perioperatively. In conclusion, we found that a high dose of remifentanil can adequately control hemodynamics in patients with uncontrolled pheochromocytoma.