Careful peri-operative management of a patient with a secretory phaeochromocytoma or paraganglioma (PPGL) is essential to help minimise peri-operative haemodynamic instability (HDI) and other potential complications of surgical resection. Most practitioners and guidelines advocate pre-operative adrenergic blockade (1). However, along with many other rare conditions, best management is often guided by clinical expertise and experience, and in this particular condition, the vast majority of data are retrospective. As far as the authors are aware, there is only one prospective contemporary study analysing outcomes of phaeochromocytoma blockade (2).
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