Dexmedetomidine and magnesium sulfate in the perioperative management of a child undergoing laparoscopic resection of bilateral pheochromocytomas

The case of an 8 year-old boy undergoing resection of pheochromocytoma, who received a combination of dexmedetomidine and magnesium sulfate (MgSO4) for hemodynamic control, is reported. He was prepared for surgery with phenoxybenzamine and atenolol. Dexmedetomidine was started in the preoperative holding area and, with MgSO4, continuously infused for most of the case. Good cardiovascular stability was achieved, but low-dose esmolol and nicardipine infusions were required during tumor manipulation. There was minimal post-resection hypotension, the neuromuscular block was easily antagonized, and the child's trachea was quickly extubated.