The intraoperative medical management of childhood pheochromocytoma.

The intraoperative medical management of eight children, ages 6--15 yr, with familial benign pheochromocytoma is described. All patients received a standardized regimen of alpha- and beta-adrenergic blocking drugs during a preoperative period ranging from 5 to 20 days. In six patients, all symptoms, including diaphoresis, palpitations and hypertension became well-controlled and the operative course was uneventful. In two others the cardiovascular symptoms persisted despite gradual increases in the above medications; in these two patients, the addition of sodium nitroprusside resulted in satisfactory titration of blood pressure and permitted performance of the operation with minimal complications. The specific treatment guidelines used in our patients may reduce the intraoperative complications previously encountered in this tumor.