Both preoperative alpha and calcium channel blockade impact intraoperative hemodynamic stability similarly in the management of pheochromocytoma
| Autor: | Brendan M. Finnerty, Laurent Brunaud, Eric Mirallié, Adeline Germain, Myriam Boutami, Laurent Bresler, Thomas J. Fahey, Rasa Zarnegar, Phi-Linh Nguyen-Thi, Georges Weryha |
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| Přispěvatelé: | Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Chirurgie Digestive et Endocrinienne [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Epidémiologie et Evaluations Cliniques [CHRU Nancy] (Pôle S2R), Department of Surgery [New York Presbyterian Hospital - Weill Cornell Medical College], Weill Medical College of Cornell University [New York]-New York Presbyterian Hospital, Service d'Endocrinologie [CHRU Nancy], Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV) |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Mean arterial pressure Databases Factual medicine.medical_treatment [SDV]Life Sciences [q-bio] Adrenal Gland Neoplasms 030209 endocrinology & metabolism Pheochromocytoma Preoperative care Risk Assessment Cohort Studies 03 medical and health sciences 0302 clinical medicine Reference Values Monitoring Intraoperative Preoperative Care medicine Humans cardiovascular diseases Intraoperative Complications Adrenergic alpha-Antagonists Antihypertensive Agents Aged Retrospective Studies business.industry Adrenalectomy Calcium channel Hemodynamics Retrospective cohort study Middle Aged medicine.disease Calcium Channel Blockers 3. Good health Blood pressure Treatment Outcome 030220 oncology & carcinogenesis Anesthesia Surgery Female business Cohort study Follow-Up Studies |
| Zdroj: | Surgery Surgery, Elsevier, 2014, 156 (6), pp.1410-1418. ⟨10.1016/j.surg.2014.08.022⟩ |
| ISSN: | 1532-7361 0039-6060 |
| DOI: | 10.1016/j.surg.2014.08.022⟩ |
| Popis: | International audience; BACKGROUND:Alpha-blockade is the standard management preoperatively to prevent intraoperative hemodynamic instability (IHD) during resection of a pheochromocytoma. Calcium channel blockers also have been shown to lessen the risk of IHD. We aim to determine differences between these classes of antihypertensive agents in minimizing IHD.METHODS:This was a retrospective analysis from a tri-institutional database. Inclusion criteria were unilateral transabdominal adrenalectomy for pheochromocytomas between 2002 and 2012. IHD was defined as at least one systolic blood pressure (SBP) measurement >160 mm Hg and at least one episode of mean arterial pressure 60 mm Hg.RESULTS:A total of 155 patients were included: 110 receiving calcium channel blockers, 41 alpha-blockade, and 4 no medication. Intraoperatively, mean maximal SBP was less after alpha-blockade (P < .0001) as well as the incidence and duration of episodes of SBP >200 mm Hg (P < .01); however, severe hypotensive episodes (MAP |
| Databáze: | OpenAIRE |
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