Combined Epidural General anesthesia is a safe approach for patients with Conn's syndrome undergoing adrenalectomy, provided preoperative blood pressure and electrolytes are optimized.
May support combined epidural-general anesthesia in optimized Conn's syndrome; hypothesis-generating and should not change practice without further evidence.
We present the perioperative management of a patient with Conn’s Syndrome posted for laparoscopic left adrenalectomy. Primary hyperaldosteronism (Conn’s Syndrome) is characterized by autonomous excessive aldosterone secretion leading to sodium retention and a fall in serum potassium. Conn’s Syndrome is a surgically curable cause of secondary hypertension. Most anesthetic problems are related to hypertension and hypokalemia and high chances of perioperative bradycardia, hypotension, hypokalemia and metabolic alkalosis. The manipulation of adrenal gland during dissection and resection may lead to catecholamine release from the adrenal medulla with resultant hemodynamic fluctuations. Anesthesia for Conn’s syndrome can be safely administered with the Combined Epidural General anesthesia technique with adequate preoperative control of blood pressure and normalization of electrolytes and strict perioperative monitoring.
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