Skin Blood Flow and Plasma Catecholamines during Removal of Pheochromocytoma

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説明

PREOPERATIVE α-adrenergic blockade is thought to reduce perioperative morbidity of patients undergoing removal of pheochromocytoma. 1 In addition, β-adrenergic blockade is also used to control tachycardia and dysrhythmias. However, a sudden decrease in plasma catecholamine concentrations after removal of the tumor often results in marked hypotension. 1,2 No clinical measure that reflects and monitors rapid changes occurring in plasma levels of catecholamines during manipulation of pheochromocytoma has been available yet, except for the measurement of blood pressure that reflects changes in systemic vascular resistance. Therefore, rapid fluid infusion under careful cardiovascular monitoring, immediately after ligation of adrenal veins or at removal of the tumor, has been recognized as the treatment of choice for this hypotension. 1-4 In a search for a measure that may correlate with rapidly changing plasma levels of catecholamine, we measured blood pressure, skin blood flow (SBF), and plasma catecholamine concentrations in three patients undergoing removal of pheochromocytoma. Skin blood flow in the first toe, measured by laser Doppler flowmetry, more closely followed rapid changes in plasma catecholamine concentrations than did blood pressure.

収録刊行物

  • Anesthesiology

    Anesthesiology 85 (6), 1485-1488., 1996-12-01

    Ovid Technologies (Wolters Kluwer Health)

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