A 67-year-old man with a presumptive diagnosis of a pheochromocytoma presents for elective adrenalectomy the following morning. His past medical history is unremarkable, except for symptoms leading to the establishment of his clinical diagnosis. Approximately 6 months before admission, the patient suffered from spontaneous episodes of headaches, sweating, and frequent palpitations. Because of these symptoms, he sought the advice of his internist, who ordered a series of tests that included determination of urinary catecholamines and metabolite concentrations.
Results of these tests were elevated above normal values, and a subsequent computed tomography scan of the abdomen confirmed the presence of an adrenal mass. The internist started the patient on oral phenoxybenzamine therapy (10 mg by mouth, twice daily) in preparation for the surgical resection. What should be anesthetic choices…
