Haemodynamic changes during retroperitoneoscopic adrenalectomy for phaeochromocytoma

Surgical removal of phaeochromocytoma may be accompanied byacute cardiovascular changes. We report the haemodynamic changesin seven patients with retroperitoneal laparoscopic adrenalectomyfor phaeochromocytoma. Transient hypertension (systolic pressure(SBP) >160 mm Hg) was observed in all patients during manipulationof the tumour, in two patients during pneumoretroperitoneuminsufflation, and in one patient during intubation. Small dosesof nicardipine were sufficient to control these episodes ofhypertension. Transient hypotension (SBP <100 mm Hg) wasobserved in two patients during exsufflation and in one patientduring repositioning to the lateral position. Our observationssuggest that this approach provides relative haemodynamic stability,especially during pneumoretroperitoneum insufflation. Br J Anaesth 2001; 86: 731–3