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Ahead of print
Original articles
Published online: 2017-07-17
Submitted: 2017-04-20
Accepted: 2017-07-04
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Comparison of phenoxybenzamine and doxazosin in perioperative management of patients with pheochromocytoma

Klaudia Malec, Piotr Miśkiewicz, Agnieszka Witkowska, Ewa Krajewska, Sadegh Toutounchi, Zbigniew Gałązka, Mariusz Piotrowski, Agata Kącka, Tomasz Bednarczuk, Urszula Ambroziak
DOI: 10.5603/KP.a2017.0147

open access

Ahead of print
Original articles
Published online: 2017-07-17
Submitted: 2017-04-20
Accepted: 2017-07-04

Abstract

Background: adrenalectomy with preoperative pharmacological preparation is strongly recommended in patients diagnosed with pheochromocytoma in order to prevent perioperative complications.

Aim: to compare phenoxybenzamine and doxazosin in terms of perioperative hemodynamic status in patients with pheochromocytoma prepared to adrenalectomy.

Methods: retrospective analysis of 44 patients with pheochromocytoma (aged 16-80 yr, female-29) who underwent adrenalectomy. Patients were divided into two groups: 35 patients on doxazosin (DOX) and 9 patients on phenoxybenzamine (PhB).

Results: mean time of preparation for surgery was 38.8 in DOX group and 18.3 days in PhB (p = 0.04). No statistically significant differences between DOX and PhB groups in intraoperative blood pressure (BP) fluctuations were found: < 170/100 mmHg (34% vs 44% respectively, p = 0.42), ³ 200/110 mmHg (40% vs 22%, respectively, p = 0.28). Mean greatest intraoperative systolic BP (195 ± 53 vs 166 ± 42, p = 0.21), diastolic BP (98 ± 20 vs 89 ± 46, p = 0.21) and mean lowest intraoperative systolic BP (87 ± 13 vs 79 ± 17, p = 0.25) and diastolic BP (49 ± 8 vs 46 ± 12, p = 0.60) were not different between DOX and PhB groups, respectively. Sodium nitroprusside was administrated in 30% DOX vs 11% PhB patients, (p = 0.25). Laparoscopic surgery was conducted in 97% DOX vs 89% PhB patients (p = 0.64). Postoperative BP drop below 90/60 mm Hg was noted in 48% DOX vs 43% PhB group (p = 0.56). Negative correlation was found between the length of doxazosin administration with maximal intraoperative systolic BP (r= –0.45, p = 0.006) and diastolic BP (r =  –0.39, p = 0.019).

Conclusions: there are no clinically relevant differences between patients with pheochromocytoma prepared to adrenalectomy with DOX or PhB.

Abstract

Background: adrenalectomy with preoperative pharmacological preparation is strongly recommended in patients diagnosed with pheochromocytoma in order to prevent perioperative complications.

Aim: to compare phenoxybenzamine and doxazosin in terms of perioperative hemodynamic status in patients with pheochromocytoma prepared to adrenalectomy.

Methods: retrospective analysis of 44 patients with pheochromocytoma (aged 16-80 yr, female-29) who underwent adrenalectomy. Patients were divided into two groups: 35 patients on doxazosin (DOX) and 9 patients on phenoxybenzamine (PhB).

Results: mean time of preparation for surgery was 38.8 in DOX group and 18.3 days in PhB (p = 0.04). No statistically significant differences between DOX and PhB groups in intraoperative blood pressure (BP) fluctuations were found: < 170/100 mmHg (34% vs 44% respectively, p = 0.42), ³ 200/110 mmHg (40% vs 22%, respectively, p = 0.28). Mean greatest intraoperative systolic BP (195 ± 53 vs 166 ± 42, p = 0.21), diastolic BP (98 ± 20 vs 89 ± 46, p = 0.21) and mean lowest intraoperative systolic BP (87 ± 13 vs 79 ± 17, p = 0.25) and diastolic BP (49 ± 8 vs 46 ± 12, p = 0.60) were not different between DOX and PhB groups, respectively. Sodium nitroprusside was administrated in 30% DOX vs 11% PhB patients, (p = 0.25). Laparoscopic surgery was conducted in 97% DOX vs 89% PhB patients (p = 0.64). Postoperative BP drop below 90/60 mm Hg was noted in 48% DOX vs 43% PhB group (p = 0.56). Negative correlation was found between the length of doxazosin administration with maximal intraoperative systolic BP (r= –0.45, p = 0.006) and diastolic BP (r =  –0.39, p = 0.019).

Conclusions: there are no clinically relevant differences between patients with pheochromocytoma prepared to adrenalectomy with DOX or PhB.

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Keywords

pheochromocytoma, blood pressure, adrenalectomy, doxazosin, phenoxybenzamine, alpha adrenolytics

About this article
Title

Comparison of phenoxybenzamine and doxazosin in perioperative management of patients with pheochromocytoma

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Ahead of print

Published online

2017-07-17

DOI

10.5603/KP.a2017.0147

Keywords

pheochromocytoma
blood pressure
adrenalectomy
doxazosin
phenoxybenzamine
alpha adrenolytics

Authors

Klaudia Malec
Piotr Miśkiewicz
Agnieszka Witkowska
Ewa Krajewska
Sadegh Toutounchi
Zbigniew Gałązka
Mariusz Piotrowski
Agata Kącka
Tomasz Bednarczuk
Urszula Ambroziak

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