Anaesthetic management of patients with phaeochromocytoma.

The presence of a phaeochromocytoma is a hazardous and dramatic cause of arterial hypertension accounting for approximately fewer than 0.1% of all cases of hypertension (Manger and Gifford, 1977). Phaeochromocytomas are functionally active, catecholamine-containing tumours of chromaffin tissue, found usually in the adrenal medulla, but they may occur at any site where chromaffin tissue is located. Although the frequency of phaeochromocytoma is low, its diagnosis is important. Whereas the hypertension is usually cured by surgical removal of the tumour, undetected phaeochromocytoma is usually fatal. Although anaesthesia in patients with unsuspected phaeochromocytoma is associated with a high mortality rate, recent reports describing anaesthetic management of patients for elective removal of phaeochromocytoma have shown that perioperatdve mortality may be almost completely eliminated (Remine et al., 1974; Desmonts et al., 1977; Roizen et al., 1982). This reduction in operative mortality is the result of our increased knowledge of the pathophysiology of the tumours. This review summarizes the data from the literature regarding the diagnosis of phaeochromocytoma and the anaesthetic management of patients with these tumours.