Use of Diltiazem to Control Circulatory Fluctuations During Resection of a Phaeochromocytoma

Tokioka, Hiroaki; Takahashi, Tohru; Kōsogabe, Yoshinori; Ohta, Yoshihiro; Kosaka, Futami

doi:10.1093/bja/60.5.582

Cited by 15 publications

(7 citation statements)

References 21 publications

(31 reference statements)

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“…[98] Unlike phenoxybenzamine, calcium channel blockers will not cause dangerous hypotension and are relatively short acting. It is especially useful for normotensive patients or those with very mild hypertension.…”

Section: Pharmacological Treatment Of Pheochromocytomamentioning

confidence: 99%

Hypertension in Pheochromocytoma: Characteristics and Treatment

Zuber

Kantorovich

Pacák

2011

Endocrinology and Metabolism Clinics of North America

164

107

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Section: Pharmacological Treatment Of Pheochromocytomamentioning

confidence: 99%

Hypertension in Pheochromocytoma: Characteristics and Treatment

Zuber

Kantorovich

Pacák

2011

Endocrinology and Metabolism Clinics of North America

164

107

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“…[12] reported haemodynamic stability in the management of a case of phaeochromocytoma using a midazolam‐sufentanil anaesthetic. Other authors have suggested that calcium channel blockers and magnesium infusions may be able to interfere with the synthesis and release of catecholamines during tumour manipulation [13, 14]. However, hypotension may be protracted after tumour removal with the use of such agents.…”

Section: Discussionmentioning

confidence: 99%

The use of remifentanil in the anaesthetic management of patients undergoing adrenalectomy: A report of three cases

Breslin¹,

Farling

Mirakhur

2003

Anaesthesia

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SummaryThe use of remifentanil has been recommended because of its ability to minimise the hypertensive response to tracheal intubation and surgical stimulation in various types of surgery. We describe the use of remifentanil in the anaesthetic management of three cases of open adrenalectomy, two for removal of a phaeochromocytoma and one for removal of an adrenal cortical tumour. Although the use of remifentanil was associated with no adverse events in the patient undergoing resection of the adrenal cortical tumour, its administration was associated with significant hypotension and bradycardia in the two phaeochromocytoma patients, who had both been given a-and b-adrenergic receptor blocking drugs before surgery. It did not prevent the increases in blood pressure or plasma catecholamine levels associated with tumour manipulation in these patients. Remifentanil should therefore be used with caution in patients receiving a-and b-adrenergic receptor blocking drugs. The use of potent vasodilators may still be necessary during tumour manipulation even if remifentanil is being infused.

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“…As described by Dr. Emmanuel Bravo (Cleveland Clinic, Cleveland, Ohio), calcium channel blockers (the dihydropyridines) may also be suitable for control of blood pressure and symptoms in patients with pheochromocytoma 29–34 . Because these drugs do not cause orthostatic or postoperative hypotension, their use seems particularly appropriate in patients who are normotensive but who suffer from occasional hypertensive paroxysms.…”

Section: Preoperative Medical Treatmentmentioning

confidence: 99%

Management and Treatment of Pheochromocytomas and Paragangliomas

Mannelli

2006

Annals of the New York Academy of Sciences

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Pheochromocytomas and paragangliomas are rare neural crest-derived tumors of sympathetic (generally catecholamine producing) or parasympathetic (rarely catecholamine producing) origin. Patients affected by these tumors present with a variable clinical picture, often making diagnosis troublesome. Surgery is the treatment of choice, but requires appropriate medical management before, during, and after tumor resection. Appropriate follow-up of patients is particularly important to identify recurrences, remaining disease, or developing malignancy. Currently, however, no firm guidelines exist about what form follow-up should take. There is also a general lack of prospective studies establishing the best approaches for management and treatment of the tumor. Choice of the many available different therapeutic options instead usually depends on institutional experience and clinical setting, which may vary for different groups of patients. At the First International Symposium on Pheochromocytoma (ISP2005), held in Bethesda in October 2005, a panel of experts addressed and discussed the many therapeutic options and problems associated with management and treatment of patients with pheochromocytoma, reporting their personal experience and sharing their opinions with those of patient representatives. The aim of this special Discussion Session was to reconcile differences of opinion and reach agreement about appropriate management and therapeutic options. This article summarizes the discussion and the recommendations derived from that session.

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Use of Diltiazem to Control Circulatory Fluctuations During Resection of a Phaeochromocytoma

Cited by 15 publications

References 21 publications

Hypertension in Pheochromocytoma: Characteristics and Treatment

Hypertension in Pheochromocytoma: Characteristics and Treatment

The use of remifentanil in the anaesthetic management of patients undergoing adrenalectomy: A report of three cases

Management and Treatment of Pheochromocytomas and Paragangliomas

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