Prospective Study to Compare Peri‐operative Hemodynamic Alterations following Preparation for Pheochromocytoma Surgery by Phenoxybenzamine or Prazosin

Abstract

PBZ was found superior to PRZ in having fewer intraoperative hemodynamic fluctuations.

Bidirectional effects of dexmedetomidine on human platelet functions in vitro

“…Therefore, the effects of dexmedetomidine on bleeding might depend on whether dexmedetomidine is administered together with drugs blocking the α 2 -adrenoreceptor, such as yohimbine, a selective α 2 -antagonist used for treatment of male sexual dysfunction (Tam et al, 2001), and phenoxybenzamine, a non-selective α-antagonist used for perioperative management of pheochromocytoma (Agrawal et al, 2014). The effects of dexmedetomidine on hemostasis might be more apparent in patients whose platelet number in the blood is seriously decreased by 15 a variety of pathophysiological mechanisms.…”

Predictors of Hemodynamic Instability During Surgery for Pheochromocytoma

“…While the increased number of episodes of SBP >200mmHg is concerning because of the potential increase risk of cardiovascular and cerebrovascular events associated with these pressures, 23 we and others have not been able to document any of such complications. 3,4,[13][14][15] Weingarten and colleagues compared the intraoperative and postoperative course of patients undergoing pheochromocytoma resection at two large tertiary care centers with differing approaches to preoperative blockade (n=49 vs. n=24) and found more episodes of intraoperative hypertension with selective blockade compared to non-selective blockade but no difference in outcomes. 15 Zhu and colleagues compared perioperative HDI of 67 patients, 31 treated with PXB and 36 with doxazosin and found that the intraoperative SBP was higher in the group treated with doxazosin but there was less variability in the intraoperative and postoperative SBP, thus they concluded that greater hemodynamic stability was achieved with selective blockade.…”

“…3,12,13 Other authors have reported either no difference or more episodes of intraoperative hypertension with the use of selective blockade when compared to PXB. [14][15][16] This study examines our center's experience with adrenal-based pheochromocytoma resections in an attempt to identify patient and tumor factors predictive of HDI. We also evaluate the effectiveness of selective alpha-blockade compared to the classically used nonselective blocking agent PXB.…”

Case 7---2015

“…22 Other authors successfully reported use of doxazosin and prazosin for reasons of a shorter duration of action and cost-effectiveness. 15,23 The addition of beta-blocker therapy in patients with preserved cardiac function helps control tachycardia and myocardial oxygen demand. Calcium channel blockers such as nifedipine, nicardipine, and verapamil have been used increasingly in recent years as well.…”