Postoperative Management

When the blood pressure has reached stability in the operating room with the use of fluids, blood, and vasopressors, if necessary, patients often remain remarkably normotensive throughout their remaining hospital course. However, persistent need for vasopressors may be required until the combined effect of the phenoxybenzamine plus lack of the intense catecholamine stimulation resolves. Monitoring in an intensive care unit may be indicated for 24 hours but is rarely necessary beyond this time. Approximately 2 weeks after the operation, a 24-hour urine collection for metanephrines and catecholamines should be obtained. This establishes that all tumor has been removed and sets a baseline for future reference. Because metastatic disease may not become apparent for over 5 years,44 similar annual screening should continue for at least that long.

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