Anesthetic Management of Pheochoromocytoma with Magnesium Sulphate

Abstract

A 41-year-old male with von Hippel Lindau's syndrome received a resection of the left adrenal gland and the right kidney for left adrenal pheochromocytoma and bilateral renal cell carcinomas. He was anesthetized with epidural infusion of fentanyl and with ventilation of a mixture of oxygen, N₂O and sevoflurane.
Continuous infusion of magnesium sulphate maintained serum magnesium concentration between 3.8∼4.2mg/dl. With these magnesium levels, we were able to obtain stability of circulation and avoid using other cardiovascular agents.
The effect of vecuronium was prolonged in accordance with serum magnesium concentra-tion. Titrating magnesium infusion while monitoring its serum concentration is important to avoid hypotension after removal of a tumor and to obtain satisfactory recovery of muscular strength after operation.