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Anesthetic management of a case of pheochromocytoma using bioreactance method with Cheetah-NICOM monitor

<p><strong>Pheochromocytoma is a rare neoplasm originating from the chromaffin cells of the adrenal gland. The number of diagnosed and excised adrenal lesions has steadily increased over the last few decades. Contemporarily, improved monitoring systems and therapeutic advances have reduced mortality associated with this disease. During surgery the anesthesiologist must be ready to face sudden hemodynamic, metabolic and electrolyte fluctuations due to the release of catecholamines.&nbsp; In this Case Report, we describe a particularly complex anesthesiologic management of a large secretory lesion by using Cheetah Non-Invasive Cardiac Output Monitor (Cheetah-NICOM monitor), non-invasive hemodynamic monitoring system.&nbsp; A 72-year-old female patient was subjected to adrenalctomy after a diagnosis of an adrenal mass (5 cm) compatible with pheochromocytoma (highlighted by metanephrine dosage). Patient reports recurrent episodes of hypertensive crisis, sweating and precordial pain and was also affected by Type 2 diabetes mellitus.&nbsp; Adrenal surgery for pheochromocytoma results in a significant increase in heart rate and peripheral vascular resistance, which should therefore be monitored to guide the infusion of medicinal products.&nbsp; Although a preoperative preparation with Alpha and beta blockers was carried out, high doses of short-lived beta-blockers and alphalytic and vasodilator were required during the intervention.&nbsp;&nbsp;This case report shows that Cheetah-NICOM monitor allowed us to manage prompty and optimally the catecholaminergic storm and the volemic filling obtaining a rapid postoperative recovery.</strong></p>