RESUMEN
We analysed the perioperative course of 17 surgeries in 16 patients with pheochromocytoma between January 1981 and February 1995. The proportion of women was high (14/16 = 88%). All patients, except one, had hypertension (in three it was only sporadic). Twelve patients had complications or associated diseases. In 13 cases the pheochromocytoma was diagnosed before the operation: they were given preoperative pharmacological protection. The intraoperative monitoring included ECG, invasive blood pressure, CVP and when considered useful, a pulmonary catheter. During tumor handling, the increase in arterial pressure reached a higher level (p < 0.01) in the patients who did not receive preoperative adrenergic blockade versus those who did receive it (p < 0.05). Intraoperative nitroprussiate was needed in 13 cases (76%). Following tumour removal five patients required vasopressor support. One patient died two weeks after surgery due to septic shock. In the postoperative period eight patients had hypokalemia, a complication which has not been reported previously.
Asunto(s)
Neoplasias de las Glándulas Suprarrenales/cirugía , Feocromocitoma/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Se informa un caso de tetanos generalizado grave, tratado con dantroleno. Inicialmente el enfermo se manejo en la forma convencional con diazepan y cloropromazina, presentando depresion en el estado de conciencia y de la funcion respiratoria. El uso del dantroleno (100 mg/dia), produjo una excelente respuesta miorrelajante, con minima depresion respiratoria. Se corroboro la accion terapeutica al reaparecer el cuadro espastico 12 horas despues de suspender el dantroleno, y desaparecer al reiniciarlo