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KMID : 0376119760030020073
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Medical Journal of the Red Cross Hospital
1976 Volume.3 No. 2 p.73 ~ p.77
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An Anesthetic Experience of Bilateral Adrenalectomy for Cushing´s Syndrome
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金?烈/Kim, Hong Youl
朴昌吉/崔美蘭/李東基/Park, Chang Kil/Choi, Mi Ran/Lee, Dong Ki
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Abstract
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We have experienced a case of anesthesia of bilateral adrenalectomy for Cushing´s syndrome in 34 year-old woman.
Anesthesia induced with thiopental sodium intravenously followed by nitrous oxide-oxygenhalothane. Succinylcholine iodide was given intravenously and -trachea was intubated. Anesthesia was maintained with halothane-nitrous oxide-oxygen using a closed carbon dioxide absorption system, and ventilation was controlled. Pancuronium bromide was used for muscular relaxation during anesthesia.
During palpation of right adrenal I tumor the pulse became more rapid and arterial pressure was markedly elevated. The ECG revealed rapid paroxysmal tachycardia with frequent premature ventricular contractions. Fortunately the condition. was improved quickly by discontinuance off surgical manipulation and anesthetics, and hyperventilation with oxygen.
Recently, several cases in which Cushing´s syndrome was, associated with paroxysmal tachycardia during adrenalectomy has been reported, with increased urinary catecholamine levels discovered retrospectively, and with an apparently unique mixed adrenal cortical adenomapheochromocytoma. It is unfortunate that urinary catecholamine levels could not be obtained retrospectively in this case.
When the anesthesia of adrenalectomy for Cushing´s syndrome is made, particularly if adrenal medullary activity has not been evaluated; it should be considered the possible presence of unsuspected pheochromocytomas.
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