High dose intravenous labetalol for the resection of metastatic pheochromocytoma.

A case of intrahepatic metastatic pheochromocytoma with lymph nodes involvement undergoing resection of tumor was reported; intravenous labetalol in high dose regimen (2 mg/kg administered before skin incision) was used for blood pressure control during the operation. Marked sinus bradycardia was noted after receiving total dose of intravenous labetalol and treated [corrected] with intravenous atropine 0.4 mg. The total operation time was 6.5 h. We found that under isoflurane anesthesia, duration of action of intravenous labetalol was prolonged as adequate intraoperative blood pressure control was obtained throughout the 6-h surgical period without further need of supplementary medication. This finding suggested that duration of labetalol was extended when concomitantly used with isoflurane and the labetalol dosage in our regimen could be effectively used in surgical procedures lasting for more than 6 h.