Peri-operative management of pheochromocytoma with intravenous urapidil to prevent hemodynamic instability: A 17-year experience
| Autor: | Grégoire Robert, Patrick Tauzin-Fin, François Sztark, Jean-Christophe Bernhard, Kévin Barrucand, Stéphanie Roullet, Musa Sesay, Philippe Gosse |
|---|---|
| Přispěvatelé: | Biologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Tachycardia
Clinique hypertension Nicardipine lcsh:RS1-441 030204 cardiovascular system & hematology Urapidil anesthesia Pheochromocytoma lcsh:RD78.3-87.3 lcsh:Pharmacy and materia medica 03 medical and health sciences urapidil 0302 clinical medicine medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics business.industry Retrospective cohort study Perioperative medicine.disease Esmolol pheochromocytoma 3. Good health Anesthesiology and Pain Medicine catecholamine lcsh:Anesthesiology 030220 oncology & carcinogenesis Anesthesia Catecholamine Original Article medicine.symptom business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology medicine.drug |
| Zdroj: | Journal of Anaesthesiology Clinical Pharmacology, Vol 36, Iss 1, Pp 49-54 (2020) Journal of Anaesthesiology Clinical Pharmacology Journal of Anaesthesiology Clinical Pharmacology, Medknow Publications, In press, 36 (1), pp.49. ⟨10.4103/joacp.JOACP_71_18⟩ Journal of Anaesthesiology, Clinical Pharmacology |
| ISSN: | 0970-9185 |
| DOI: | 10.4103/joacp.JOACP_71_18⟩ |
| Popis: | Background and Aims: Surgery for pheochromocytoma (PCC) can cause excessive catecholamine release with severe hypertension. Alpha blockade is the mainstay of preoperative management. The aim of this study was to evaluate the efficacy and tolerance of intra-venous (IV) urapidil, a competitive short acting α1 receptor antagonist, in the prevention of peri-operative hemodynamic instability of patients with PCC. Material and Methods: This retrospective observational study included 75 patients (79 PCC) for PCC removal surgery from 2001 to 2017 at the Bordeaux University Hospital. They received, 3 days before surgery, continuous intravenous infusion of urapidil with stepwise increase to the maximum tolerated dose. Urapidil was maintained during the procedure and stopped after clamping the adrenal vein. Plasma catecholamine concentrations were measured during surgery. Hypertensive peaks (SAP >160 mmHg) and tachycardia >100 beats/min were treated with boluses of nicardipine 2 mg and esmolol 0.5 mg/kg. Results: We recorded 20/79 (25%) cases with systolic arterial pressure (SAP) >180 mmHg. Only 11/79 (14%) had hypotension with SAP |
| Databáze: | OpenAIRE |
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