Background:Phaeochromocytoma resection surgery implies potential hemodynamic instability that may require the use of vasoactive drugs to achieve an adequate blood pressure control. In this line, new drugs could be used as antihypertensives in this kind of surgery, in our case clevidipine.
Case Report:A 64-year old woman is admitted in our hospital for laparoscopic adrenalectomy in the context of a phaeochromocytoma. Other medical record: arterial hypertension with hypertensive cardiopathy, left ventricle hypertrophy, multinodular goitre, anxiety disorder. The patient is prepared for surgery with
adrenergic blockade and volume optimization. Once the patient is optimized, she is taken to the operating theatre for surgery. After anesthetic induction with close blood pressure monitoring with an arterial cannula surgery starts. As the surgeon manipulates de tumour a hypertensive peak (SBP>180mmHg) occurs. A continuous infusion of clevidipine is administered with a maximum speed of 16mg/h. During the whole procedure hemodynamic stability is assured. Once the tumour is removed from the patient the requirement of clevidipine drops to 4mg/h, which continues to be necessary for some hours in the ICU. The next day the patient presents blood pressure values that can be controlled with oral nifedipine which allows to withdraw
the clevidipine continuous infusion. The patient is discharged from the ICU to regular hospitalization area with optimal blood pressure control.
Discussion:Clevidipine continuous infusion use in phaeochromocytoma surgery is not common. Clevidipine can be a new and very useful resource to be introduced in this kind of surgery. Its rapid onset of effect and ultra-short half-life make it a really interesting drug. On top of that it has a very low incidence of adverse effects and it can be very easily titrated to get to our target blood pressure.

04 / Introducing clevidipine in phaeochromocytoma surgery protocols