Bilateral phaeochromocytomas in pregnancy: anaesthetic management of combined caesarean section and tumour removal.

A 25-year-old primigravida with bilateral phaeochromocytomas was managed from 6 weeks' gestation until 2.5 years following combined Caesarean section and removal of adrenal tumours. Pre-operative alpha-blockade was achieved by oral prazosin without deleterious effects. Intra-operative management comprised neuroleptanalgesia, arterial and pulmonary pressure monitoring, adequate heart loading with fluid replacement and sodium nitroprusside. Post-operatively, mother and baby remained normotensive.