Anesthetic management for percutaneous computed tomography-guided radiofrequency ablation of reninoma: a case report

Abstract

A reninoma is an uncommon, benign, renin-secreting juxtaglomerular cell tumor that causes secondary hypertension in young patients. This hypertension is treated by tumor resection. Except for increased levels of plasma renin and angiotensin I and II, the other physical and laboratory examinations and electrocardiographs were within normal limits upon admission of a 19-year-old woman with a reninoma. For percutaneous computed tomography-guided radiofrequency ablation, general anesthesia was induced by thiopental sodium and rocuronium bromide and maintained with servoflurane (2-4 vol%) and oxygen. The operation ended uneventfully in hemodynamic stability. However, the patient complained of dizziness while sitting 5 hours after the operation, and hypotension was diagnosed. After aggressive normal saline (1 L) infusion over 30 min, the hypotension was corrected and the patient recovered without any other surgical complications. Here, we report the anesthetic management of a patient who underwent percutaneous computed tomography-guided radiofrequency ablation for reninoma destruction, particularly focusing on postoperative hypotension.

Keywords: Anesthetic management; Radiofrequency ablation; Reninoma.

Fig. 1

The systolic and diastolic blood pressures (A) and heart rate (B) during the operation. SBP: systolic blood pressure, DBP: diastolic blood pressure.

Fig. 2

The systolic and diastolic blood pressures (A) and heart rate (B) in the postanesthetic care unit. SBP: systolic blood pressure, DBP: diastolic blood pressure.

Fig. 3

The systolic and diastolic blood pressures (A) and heart rate (B) in the general ward. SBP: systolic blood pressure, DBP: diastolic blood pressure.