Perioperative Hypertensive Urgency After Methylene Blue in a Patient With Undiagnosed Pheochromocytoma: A Case Report. Issue 9 (1st May 2019)

• Record Type: Journal Article
• Authors: Shukla, Shikha; Zhu, Richard; Rubin, Philip; Deshpande, Ranjit
• Is Part Of: A & A practice. Volume 12:Issue 9(2019)
• Publication Date: 2019-05-01
• Subjects: Analgesia -- Periodicals; Analgesia -- Case studies -- Periodicals; Anesthesiology -- Periodicals; Anesthesiology -- Case studies -- Periodicals; 617.9605
• DOI: 10.1213/XAA.0000000000000924
• Languages: English
• ISSNs: 2575-3126

Abstract

Abstract : We report the perioperative course of a 75-year-old woman undergoing robotic-assisted laparoscopic hysterectomy and tumor debulking. The patient developed severe, persistent hypertension after intraoperative methylene blue administration requiring a Surgical Intensive Care Unit admission with further investigative evaluation revealing a previously undiagnosed pheochromocytoma. Our discussion focuses on the differential diagnoses for her perioperative hypertension. We evaluate whether methylene blue triggered a pheochromocytoma crisis in our patient and emphasize the caution and critical thinking we all should demonstrate while providing anesthetic care.