Preoperative preparation (standardization) of pheochromocytoma is very important and is the key to treatment to avoid death…

Pre-surgical preparation: indicators that should be observed before surgery: 1) blood pressure in prone position, heart rate × 4 times/day (standing blood pressure should be measured 2-3 minutes after the patient stands up), if necessary, blood pressure and heart rate should be measured in prone position, standing position immediately, 3 minutes, 5 minutes, 10 minutes, paying attention to changes in postural blood pressure Sun Fa, Department of Urology, Affiliated Hospital of Guizhou Medical University 2) body weight (measured weekly in the morning on an empty stomach) 3) every two weeks Check blood routine (mainly pay attention to HCT changes) 4) Biweekly check the two-handed hemogram to evaluate the microvascular integral of both hands. 5) Extremity temperature 6) Blood glucose changes 7) Ambulatory blood pressure monitoring can be reviewed every 2 weeks (while leaving 12h urine catecholamines by day and night) 8) Urine catecholamines can be reviewed every 2 weeks 9) Pay attention to the number of stools indicators that need to be reviewed regularly in drug preparation: examination items repeat interval Blood routine (Hct), two-handed microcirculation, ambulatory blood pressure monitoring, 24h urinary catecholamines 2 weeks morning fasting weight 1 week drug preparation For patients with persistent hypertension, pressure ninhydrin from 30mg Q8h (phenazopyridine should be added from 5-10mg Bid), for patients with paroxysmal hypertension (usually blood pressure is not high), pressure ninhydrin from 30mg Qd ~ Q12h (phenazopyridine should be added from 5mg Qd~Bid) and gradually increase the dose, while observing blood pressure changes and adjusting the drug use. If the patient has a sustained heart rate >120bpm in the prone position or has supraventricular arrhythmias, beta blockers may be considered if alpha blockers are already being used. The drug preparation time should be from 2 weeks to 4 weeks, while depending on changes in blood pressure, etc. Indicators of readiness: 1) Approximately normal blood pressure control, significant reduction or disappearance of hypertensive episodes 2) Improvement or disappearance of hypermetabolic symptoms, such as reduced sweating, weight gain, correction of metabolic disorders such as blood glucose 3) Restoration of blood volume and improvement of peripheral circulation 4) Reduction of pre-existing postural hypotension