Clinical Autonomic Research

, Volume 4, Issue 4, pp 167–173

Phaeochromocytoma: Intraoperative changes in blood pressure and plasma catecholamines

  • Anne L. Tonkin
  • Derek B. Frewin
  • W. John Russell
  • Julie R. Jonsson
Research Paper

Abstract

The aim of this study was to assess the relationship between changes in plasma catecholamine concentrations and intraarterial blood pressure (BP) measured simultaneously during resection of phaeochromocytoma (n = 14). Arterial plasma concentrations of noradrenaline (NA), adrenaline (A) and dopamine (DA) were measured by a radio-enzymatic method. Arterial NA concentrations (pmol/ml; median and Wilcoxon 95% CI) were 71.8 (46,162) before induction of anaesthesia, 113.0 (79,231) after intubation, 375.0 (285,931) during tumour handling and 32.5 (18,88) following tumour removal. Simultaneous mean BP values (mmHg; Mean ± SEM) were 119 ± 8, 114 ± 7, 159 ± 7 (p = 0.0001) and 72 ± 6 (p < 0.0001) respectively. At the time of tumour handling there was a weak correlation between plasma NA and A combined and mean BP (r = 0.583,p = 0.029) and a stronger correlation between log plasma NA and A combined and pulse pressure (r = 0.749,p = 0.008). The very large rises in plasma catecholamine concentrations and in BP are likely to have been causally related. Individual patients maintained a constant ratio of NA to A in plasma from pre-induction to tumour handling (r = 0.916,p < 0.0001). The maintenance of a constant NA: A ratio suggests that the pattern of catecholamine synthesis and release may be a characteristic of the individual tumour.

Key words

Phaeochromocytoma Catecholamines Blood pressure Hypertension Anaesthesia 

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Copyright information

© Rapid Communications of Oxford Ltd 1994

Authors and Affiliations

  • Anne L. Tonkin
    • 1
  • Derek B. Frewin
    • 1
  • W. John Russell
    • 2
  • Julie R. Jonsson
    • 1
  1. 1.Department of Clinical and Experimental PharmacologyUniversity of AdelaideAdelaideAustralia
  2. 2.Department of Anaesthesia and Intensive CareUniversity of AdelaideAdelaideAustralia

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