As a student, I pretty much hit the clinical experience jackpot this week as I had the opportunity to provide anesthesia to 2 different patients undergoing a laparoscopic excision of a pheochromocytoma + adrenalectomy. What great cases! And I had 2 of them in a 3 day span!

So, I'll provide further details of what I did and what happened in my cases in a response forthcoming, but I would like to start a quick discussion first and get the wheels turning for us SRNAs.


Fellow students first! Without cracking open a book, or searching on google (at least see what you know first)...

What are your case considerations for a patient with a pheochromocytoma?

1. What's the deal with this tumor?
How are patients medically managed and optimized for surgery?
Preoperatively, how would you determine whether the patient is indeed optimized for this procedure?

2. How would you set up? - Equipment, meds, monitors, etc.

3. Hemodynamically, what are the most critical and dangerous moments during this case? What's your plan for treatment at these points?


Be brave. Throw something out there, as much or as little as you want. CRNAs, help guide responses, please.

Annndddddd.....GO