Co-morbidities included ischaemic heart disease (single stent), carcinoma of the prostate (endocrine therapy), hyperlipidemia, and hypertension. Case reportĪ 77-year old male patient underwent elective laparoscopic right adrenalectomy to remove a 63mm adrenal tumor causing phaeochromocytoma. The patient provided written consent for the use of de-identified data for analysis and publication in a peer-reviewed journal. At six months follow up, the patient reported no cardiovascular, neurological, or renal sequelae. The authors present the use of high dose epinephrine in the successful management of profound and protracted hypotension secondary to massive postoperative hemorrhage following laparoscopic adrenalectomy. There is emerging evidence to support the use of pre-emptive interventions to avoid and manage protracted hypotension in patients undergoing general anesthesia. Sustained intraoperative hypotension is recognized to result in significant end-organ dysfunction. In hypotension secondary to cardiogenic or anaphylactic shock, low-dose epinephrine is often used as an infusion to maintain organ perfusion. Although the high dose of epinephrine has been investigated in cardiac arrest, current recommendations do not favor its use.
BMI: Body Mass Index eGFR: Estimated Glomerular Filtration Rate MAP: Mean Arterial Pressure PEA: Pulseless Electrical Activity IntroductionĮpinephrine is widely used in the management of severe cardiovascular instability as well as in cardiac arrest.
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