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Fluroxene Anesthesia for Pheochromocytoma Removal

Thomas A. Joas, MD; Douglas Craig, MD
JAMA. 1969;209(6):927-929. doi:10.1001/jama.1969.03160190049013.
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In 1951 Apgar and Papper stated, "There appears to be no agreement in the literature on the most desirable means of anesthetic management for pheochromocytoma excision."1 This statement applies equally well today, even with better understanding of the autonomic nervous system2 and the concept of alpha- and beta-adrenergic receptors and blockers.3 Concomitant with development of adrenergic pharmacology has been the introduction of the halogenated anesthetic agents, halothane, methoxyflurane, and fluroxene. The literature is replete with reports of pheochromocytoma removal utilizing alpha- and beta-adrenergic blockade in conjunction with many general anesthetic agents.4-6 Halothane is a popular general anesthetic agent and has both advocates4 and opponents7 concerning its use alone or with other drugs. Several reports have described the use of methoxyflurane for the removal of pheochromocytoma,8,9 but, to our knowledge, there is only one published instance of fluroxene anesthesia for pheochromocytoma removal.10

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