open access

Vol 75, No 11 (2017)
Original articles
Published online: 2017-07-17
Submitted: 2017-04-20
Accepted: 2017-07-04
Get Citation

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
·
Kardiol Pol 2017;75(11):1192-1198.

open access

Vol 75, No 11 (2017)
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 (PhB) and doxazosin (DOX) in terms of perioperative haemodynamic status in patients with pheochromocytoma, who have been prepared for adrenalectomy.

Methods: Retrospective analysis of 44 patients with pheochromocytoma (aged 16–80 years, 29 females) who underwent adrenalectomy. Patients were divided into two groups: 35 patients on DOX and nine patients on PhB.

Results: Mean time of preparation for surgery was 38.8 days in the DOX group and 18.3 days in the PhB group (p = 0.04). No statistically significant differences between the DOX and PhB groups in intraoperative blood pressure (BP) fluctuations were found: < 170/100 mm Hg (34% vs. 44%, respectively, p = 0.42), ≥ 200/110 mm Hg (40% vs. 22%, respectively, p = 0.28). Mean greatest intraoperative systolic BP (195 ± 53 vs. 166 ± 42 mm Hg, p = 0.21) and diastolic BP (98 ± 20 vs. 89 ± 46 mm Hg, p = 0.21), and mean lowest intraoperative systolic BP (87 ± 13 vs. 79 ± 17 mm Hg, p = 0.25) and diastolic BP (49 ± 8 vs. 46 ± 12 mm Hg, p = 0.60) were not different between the 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% of the DOX vs. 43% of the PhB group (p = 0.56). Negative correlation was found between the length of DOX 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, who have been prepared for 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 (PhB) and doxazosin (DOX) in terms of perioperative haemodynamic status in patients with pheochromocytoma, who have been prepared for adrenalectomy.

Methods: Retrospective analysis of 44 patients with pheochromocytoma (aged 16–80 years, 29 females) who underwent adrenalectomy. Patients were divided into two groups: 35 patients on DOX and nine patients on PhB.

Results: Mean time of preparation for surgery was 38.8 days in the DOX group and 18.3 days in the PhB group (p = 0.04). No statistically significant differences between the DOX and PhB groups in intraoperative blood pressure (BP) fluctuations were found: < 170/100 mm Hg (34% vs. 44%, respectively, p = 0.42), ≥ 200/110 mm Hg (40% vs. 22%, respectively, p = 0.28). Mean greatest intraoperative systolic BP (195 ± 53 vs. 166 ± 42 mm Hg, p = 0.21) and diastolic BP (98 ± 20 vs. 89 ± 46 mm Hg, p = 0.21), and mean lowest intraoperative systolic BP (87 ± 13 vs. 79 ± 17 mm Hg, p = 0.25) and diastolic BP (49 ± 8 vs. 46 ± 12 mm Hg, p = 0.60) were not different between the 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% of the DOX vs. 43% of the PhB group (p = 0.56). Negative correlation was found between the length of DOX 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, who have been prepared for adrenalectomy with DOX or PhB.  

Get Citation

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

Vol 75, No 11 (2017)

Pages

1192-1198

Published online

2017-07-17

DOI

10.5603/KP.a2017.0147

Bibliographic record

Kardiol Pol 2017;75(11):1192-1198.

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

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl