Catecholamine excess: Probable cause of postoperative tachycardia following retroperitoneal lymph node dissection (RPLND) for testicular carcinoma

Review of the postoperative course of seven patients who underwent retroperitoneal lymph node dissection (RPLND) for staging of testicular carcinoma revealed an unexplained tachycardia that was persistent for several days. Postoperative catecholamine determinations from three subsequent patients subjected to RPLND revealed dramatic increases in epinephrine, norepinephrine, dopamine, and total catecholamines. Since cardiac acceleration is mediated almost exclusively by sympathetic stimulation, this finding may explain the postoperative tachycardia observed in these patients.