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Open Access 01-12-2022 | Dexamethasone | Case report

Hypertensive attack induced by dexamethasone during induction of anesthesia in a patient with an adrenal pheochromocytoma: a case report

Authors: Shuichiro Kurita, Yoshinori Kamiya

Published in: JA Clinical Reports | Issue 1/2022

Abstract

Background

Dexamethasone is used perioperatively as an antiemetic for postoperative nausea and vomiting. Evidence and mechanism linking dexamethasone and hypertensive attack of pheochromocytoma during anesthesia have not been reported.

Case description

We report a case of a hypertensive attack during anesthetic induction immediately after dexamethasone administration in a 35-year-old woman with adrenal pheochromocytoma. Approximately 2 min after the anesthetic drugs and dexamethasone were administered, her arterial blood pressure suddenly increased from 143/79 to 243/116 mmHg during manual mask ventilation. Since tracheal intubation had not been performed yet, dexamethasone could be a causative agent of hypertensive episodes. The surgery and anesthesia were uneventful. She was admitted to the intensive care unit to have her blood pressure controlled subsequently.

Conclusions

Dexamethasone should be used with caution in patients with adrenal pheochromocytoma on account of the risk of hypertensive attacks.

Eisenhofer G, Rivers G, Rosas AL, et al. Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention, and management. Drug Saf. 2007;30(11):1031–62.CrossRef

Naranjo J, Dodd S, Martin YN. Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth. 2017;31(4):1427–39.CrossRef

Rosas AL, Kasperlik-Zaluska AA, Papierska L, et al. Pheochromocytoma crisis induced by glucocorticoids: a report of four cases and review of the literature. Eur J Endocrinol. 2008 Mar;158(3):423–9.CrossRef

Eisenhofer G, Walther MM, Huynh TT, et al. Pheochromocytomas in von Hippel-Lindau syndrome and multiple endocrine neoplasia type 2 display distinct biochemical and clinical phenotypes. J Clin Endocrinol Metab. 2001;86(5):1999–2008.CrossRef

Title: Hypertensive attack induced by dexamethasone during induction of anesthesia in a patient with an adrenal pheochromocytoma: a case report
Authors: Shuichiro Kurita
Yoshinori Kamiya
Publication date: 01-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Dexamethasone
Rocuronium
Published in: JA Clinical Reports / Issue 1/2022
Electronic ISSN: 2363-9024
DOI: https://doi.org/10.1186/s40981-022-00547-y

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Springer Medicine

Hypertensive attack induced by dexamethasone during induction of anesthesia in a patient with an adrenal pheochromocytoma: a case report

Abstract

Background

Case description

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case description

Conclusions

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