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Anesth Analg 2005;100:972-975
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000146433.84742.3A

PEDIATRIC ANESTHESIA

The Perioperative Management of a Patient with Complex Single Ventricle Physiology and Pheochromocytoma

J. William Sparks, MD*, Christian Seefelder, MD*, Robert C. Shamberger, MD{ddagger}, and Francis X. McGowan, MD{dagger}

*Division of Perioperative Medicine and {dagger}Division of Cardiac Anesthesia, Department of Anesthesiology, Perioperative and Pain Medicine, and {ddagger}Department of Surgery, Children's Hospital and Harvard Medical School, Boston, Massachusetts

Address correspondence and reprint requests to Christian Seefelder, MD, Department of Anesthesia, Children's Hospital, 300 Longwood Ave, Boston, MA 02115. Address e-mail to christian.seefelder{at}childrens.harvard.edu.

Pheochromocytoma is associated with intense physiologic effects of {alpha}- and ß-adrenergic stimulation from catecholamine secretion. Perioperative management for these patients includes {alpha}-adrenergic receptor blockade, intravascular volume replacement, and, if necessary, ß-adrenergic receptor blockade. Significant perioperative changes in preload and afterload, fluid status, heart rate and rhythm, and inotropy can occur and may be contrary to anesthetic management goals for patients with certain conditions of congenital heart disease. We report the perioperative management with doxazosin of a patient with single ventricle physiology and cavo-pulmonary and aorto-pulmonary lung perfusion who presented for resection of a pheochromocytoma.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.