JA clinical reports · 2022
Hypertensive attack induced by dexamethasone during induction of anesthesia in a patient with an adrenal pheochromocytoma: a case report.
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Kurita Shuichiro, Kamiya Yoshinori
Аннотация
BACKGROUND: Dexamethasone is used perioperatively as an antiemetic for postoperative nausea and vomiting. Evidence and mechanism linking dexamethasone and hypertensive attack of pheochromocytoma during anesthesia have not been reported.
CASE DESCRIPTION: We report a case of a hypertensive attack during anesthetic induction immediately after dexamethasone administration in a 35-year-old woman with adrenal pheochromocytoma. Approximately 2 min after the anesthetic drugs and dexamethasone were administered, her arterial blood pressure suddenly increased from 143/79 to 243/116 mmHg during manual mask ventilation. Since tracheal intubation had not been performed yet, dexamethasone could be a causative agent of hypertensive episodes. The surgery and anesthesia were uneventful. She was admitted to the intensive care unit to have her blood pressure controlled subsequently.
CONCLUSIONS: Dexamethasone should be used with caution in patients with adrenal pheochromocytoma on account of the risk of hypertensive attacks.
CASE DESCRIPTION: We report a case of a hypertensive attack during anesthetic induction immediately after dexamethasone administration in a 35-year-old woman with adrenal pheochromocytoma. Approximately 2 min after the anesthetic drugs and dexamethasone were administered, her arterial blood pressure suddenly increased from 143/79 to 243/116 mmHg during manual mask ventilation. Since tracheal intubation had not been performed yet, dexamethasone could be a causative agent of hypertensive episodes. The surgery and anesthesia were uneventful. She was admitted to the intensive care unit to have her blood pressure controlled subsequently.
CONCLUSIONS: Dexamethasone should be used with caution in patients with adrenal pheochromocytoma on account of the risk of hypertensive attacks.