European Journal of Biomedical and Pharmaceutical Sciences

ANESTHESIA FOR RESECTION OF RENIN PRODUCING ADRENAL TUMOR: A CASE REPORT

Tomoki Nishiyama MD, PhD*

ABSTRACT

Background: Renin producing adrenal tumor is extremely rare. We experienced general anesthesia for resection
of renin producing adrenal tumor. Case Report: A 67 years old female with hypertension had high plasma renin
activity and serum aldosterone level with right adrenal tumor. She was scheduled for right adrenalectomy. After
insertion of an epidural catheter, an arterial catheter, and a Swan-Ganz catheter, anesthesia was induced with
diazepam, fentanyl and vecuronium, and maintained with isoflurane, nitrous oxide, and fentanyl. Diltiazem was
infused to control blood pressure. Surgery was done under left lateral position without any complications. She was
extubated in the operating room and discharged from high care unit to the ward 2 days later. Serum aldosterone
levels decreased to the normal range before tumor removal and plasma renin activity decreased gradually to the
normal range in 10 days. Blood pressure had been slightly high after surgery during her stay in the hospital.
Conclusions: Resection of renin producing adrenal tumor was performed without any complications under general
anesthesia with isoflurane, nitrous oxide, and fentanyl plus epidural block using diltiazem for control of blood
pressure.

Keywords: Renin producing tumor, general anesthesia, epidural block, diltiazem.