Perioperative management of a child with severe hypertension from a catecholamine secreting neuroblastoma

Summary Increased catecholamine secretion from neuroblastomas can occasionally be demonstrated, but severe hypertension is uncommon. We report the perioperative management of a 5 year old child with stage III adrenal neuroblastoma who presented with malignant hypertension and high norepinephrine and...

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Bibliographic Details
Published in:Pediatric anesthesia 2005-07, Vol.15 (7), p.606-610
Main Authors: SEEFELDER, CHRISTIAN, SPARKS, J. WILLIAM, CHIRNOMAS, DEBORAH, DILLER, LISA, SHAMBERGER, ROBERT C.
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Antihypertensive Agents - therapeutic use
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
catecholamines
Catecholamines - metabolism
Catecholamines - physiology
Child, Preschool
Dopamine - blood
drugs: doxazosin
Epinephrine - blood
Female
Humans
Hypertension - drug therapy
Hypertension - etiology
Hypertension - therapy
Kidney Neoplasms - complications
Kidney Neoplasms - metabolism
Kidney Neoplasms - surgery
Magnetic Resonance Imaging
malignant hypertension
Medical sciences
neuroblastoma
Neuroblastoma - complications
Neuroblastoma - metabolism
Neuroblastoma - surgery
Norepinephrine - blood
Perioperative Care
pheochromocytoma
Preanesthetic Medication
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Description
Summary:Summary Increased catecholamine secretion from neuroblastomas can occasionally be demonstrated, but severe hypertension is uncommon. We report the perioperative management of a 5 year old child with stage III adrenal neuroblastoma who presented with malignant hypertension and high norepinephrine and dopamine levels. Hypertensive crises occurred during anesthesia for surgical biopsy and during chemotherapy. After blood pressure control using phenoxybenzamine and enalapril, doxazosin was used successfully as the preoperative α‐adrenergic receptor antagonist for surgical tumor resection.
ISSN:1155-5645
1460-9592
DOI:10.1111/j.1460-9592.2005.01631.x