关键词: β受体阻滞剂, 美托洛尔, 七氟醚, 麻醉 , 嗜铬细胞瘤, 高血压

Abstract:

Objective To explore the efficiency and risks of β blocker combined with sevoflur-ance in the management of hypertension in pheochromocytoma surgery. Methods Clinical and anaes-thetic data from 3 cases of pheochromocytoma were collected. The patients outcomes were recorded and analyzed including preoperative schedule, intraoperative hemodynamic changes after antihypertensive therapy by metoprolol combined with sevoflurane. Related literatures were reviewed. Results Adrenal adenoma was identified as phaeochromocytoma in 3 cases in our hospital. Laparoscopic adrenalectomy was performed, and phenoxybenzamine was given for preoperative preparation During the surgical exci-sion of the adenoma, severe hypertension occurred; blood pressure were measured as 170/110 mmHg, 160/90 mmHg and 160/90 mmHg respectively in three patients. Along with administration of intravenous metoprolol and deepen of the anesthetic depth, blood pressure gradually diminished to the baseline, no rebound phenomena was observed after withdrawal of medication. No post-operative hypotension was observed after transferred to the ward, and all 3 cases were discharged from hospital on the 6th-8th post-operative day. Conclusion β blocker with deepen anesthetic depth could be used for the management of hypertension in anesthesia of pheochromocytoma, of which the efficiency and safety still need further study.

Key words: anesthesia, β blocker, metoprolol, hypertension, pheochromocytoma, sevoflurane