Anesthetic Management with Blood Volume Monitoring during Surgical Resection of Pheochromocytoma

Abstract

In three patients undergoing surgical resection of pheochromocytoma, blood volume (BV) was measured using pulse spectrophotometry. In the first case, BV decreased to 44∼57ml•kg-1 during tumor resection while mean pulmonary artery and right atrial pressure was normal. After removal of tumor, high dose of dopamine was required to maintain blood pressure. In other two cases, BV were maintained at higher levels, 98 to 145, and 92 to 105ml•kg-1 with mean pulmonary arterial pressure below normal (case 2, 11 to l7mmHg) or above normal (case 3, 22 to 24 mmHg). The blood pressure after tumor resection in these two patients were maintained well without vasopressor. During resection of pheochromocytoma, BV is more helpful to estimate intravascular volume than mean pulmonary artery pressure which is influenced by catecholamine level and vasoactive drugs.