PT  - JOURNAL ARTICLE
AU  - Dr A A Syed
AU  - H A Wheatley
AU  - M N Badminton
AU  - I F W McDowell
TI  - Urinary catecholamines and metabolites in the immediate postoperative period following major surgery
AID  - 10.1136/jcp.2003.013201
DP  - 2004 May 01
TA  - Journal of Clinical Pathology
PG  - 548--550
VI  - 57
IP  - 5
4099  - http://jcp.bmj.com/content/57/5/548.short
4100  - http://jcp.bmj.com/content/57/5/548.full
SO  - J Clin Pathol2004 May 01; 57
AB  - Background: Induction of anaesthesia can precipitate catecholamine release from an undiscovered pheochromocytoma and induce a hypertensive crisis. However, it is assumed that catecholamine and metabolite values resulting from the effects of surgery per se in the early postoperative period would overlap with the values generated by a tumour, and it is not known how soon after biochemical investigations can be carried out. Aim: To study patterns of urinary catecholamine excretion and the feasibility of biochemical screening for phaeochromocytomas in the immediate postoperative period in otherwise healthy subjects undergoing a single type of major surgical procedure. Methods: Catecholamines and metabolites were measured for each mole of creatinine in single voided urine on one preoperative and four postoperative days in five subjects who underwent elective coronary artery bypass graft surgery with an uncomplicated postoperative course. Reference ranges were established from 33 healthy normotensive volunteers. Results: Excretion of adrenaline, noradrenaline, dopamine, vanillylmandelic acid, and metadrenaline was within normal limits. Normetadrenaline excretion was mildly raised in four patients, but did not exceed 1.5 times the upper reference limit, and returned to normality by the fourth postoperative day. Conclusion: It is feasible to perform simple urinary screening for possible phaeochromocytoma in the immediate postoperative period.