A 32yr old female patient presented with history of consumption of multiple anti-hypertensive drugs; patient had high blood pressure of 200/100 mm hg, she was on T.metaprolol50mg, T.Amlong5mg since 6 months. patient had headache, giddiness palpitations and increased sweating since 1 yr. patient was evaluated to have mass in upper pole of left kidney in CT abdomen and diagnosed as pheochromocytoma. We are reporting this case because of its rarity and anaesthetic management is challenging.

Anaesthetic management: pre-operatively patient Blood pressure was controlled with T.Prazosin 5mg, T.Amlodipine 5mg, T. Metaprolol 50mg. After satisfying roizens criteria, patient was posted for surgical excision. Patient was premedicated with T.ranitidine 150mg and T. alprazolam 0.25mg. Intraoperative monitoring was done with ECG, IBP, ETCO2 , SPO2 and CVP. Anaesthesia was induced with inj. Propofol, Fentanyl and intubation facilitated with Vecuronium. Anaesthesia was maintained with 02, air, Isoflurane and Vecuronium. Intraoperative B.P raised upto 200/110 mm Hg which was controlled with Nitroglycerine infusion. After resection of tumor severe hypotension occurred which was managed with fluid replacement .post op Fentanyl infusion was started for analgesia. Patient shifted on ventilatory support to Recoveryroom and extubated after 12 hrs. The further course was uneventful.