Total intravenous anesthesia in laparoscopic surgery of adrenal tumor: A case report

Abstract

Primary hyperaldosteronism is a condition characterized by excessive aldosterone production, which is not dependent on the renin-angiotensin-aldosterone system. One of the most frequent clinical manifestations is arterial hypertension resistant to conventional treatment. It is estimated that approximately 10% of cases of secondary hypertension are associated with primary hyperaldosteronism, with approximately 50% of these cases being caused by an adrenal adenoma. Adrenal gland tumors present challenges for the anesthesiologist, requiring careful preoperative evaluation and adequate hemodynamic control during the perioperative period. The objective of this clinical case is to report the use of total intravenous anesthesia in laparoscopic surgery of an adrenal tumor in a patient with primary hyperaldosteronism. The aim is to describe the anesthetic technique used, evaluate the hemodynamic response of the patient during the procedure and analyze the results obtained in terms of cardiovascular stability, pain control and prevention of postoperative complications. We present the case of a 28-year-old patient with systemic arterial hypertension of 4 years of evolution, which has been difficult to control. Due to the suspicion of primary hyperaldosteronism, the aldosterone/plasma renin activity ratio test was performed, which showed elevated levels. As part of the management, a laparoscopic left adrenalectomy was performed under total intravenous anesthesia.