Anesthesia for pheochromocytoma resection in a child with Fontan circulation.

PURPOSE: To report the anesthetic management of a successful resection of a pheochromocytoma in a child with a completed Fontan circulation. CLINICAL FEATURES: The patient was an 11-yr-old boy with Ivemark syndrome who had undergone Fontan palliation at three years of age. Six weeks earlier, he had been diagnosed with a norepinephrine-producing pheochromocytoma, and he had been pretreated with oral propranolol and phenoxybenzamine. During surgery, intravenous administration of magnesium sulphate, esmolol, and phentolamine provided good hemodynamic control. Postoperatively, the patient tended to be hypotensive, and treatment with fluid administration resulted in prolonged intensive care. CONCLUSION: Although intraoperative management was not problematic, postoperative care of this 11-yr old child with pheochromocytoma was complicated by residual sympathetic blockade.