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dc.rights.licenseopenen_US
dc.contributor.authorTAUZIN-FIN, Patrick
dc.contributor.authorBARRUCAND, Kévin
dc.contributor.authorSESAY, Musa
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorROULLET, Stéphanie
dc.contributor.authorGOSSE, Philippe
dc.contributor.authorBERNHARD, Jean-Christophe
dc.contributor.authorROBERT, Gregoire
dc.contributor.authorSZTARK, François
dc.date.accessioned2020-10-19T14:37:13Z
dc.date.available2020-10-19T14:37:13Z
dc.date.issued2020-04-10
dc.identifier.issn0970-9185en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/11437
dc.description.abstractEnBackground and Aims: Surgery for pheochromocytoma (PCC) can cause excessive catecholamine release with severe hypertension. Alpha blockade is the mainstay of preoperative management. The aim of this study was to evaluate the efficacy and tolerance of intra-venous (IV) urapidil, a competitive short acting α1 receptor antagonist, in the prevention of peri-operative hemodynamic instability of patients with PCC. Material and Methods: This retrospective observational study included 75 patients (79 PCC) for PCC removal surgery from 2001 to 2017 at the Bordeaux University Hospital. They received, 3 days before surgery, continuous intravenous infusion of urapidil with stepwise increase to the maximum tolerated dose. Urapidil was maintained during the procedure and stopped after clamping the adrenal vein. Plasma catecholamine concentrations were measured during surgery. Hypertensive peaks (SAP >160 mmHg) and tachycardia >100 beats/min were treated with boluses of nicardipine 2 mg and esmolol 0.5 mg/kg. Results: We recorded 20/79 (25%) cases with systolic arterial pressure (SAP) >180 mmHg. Only 11/79 (14%) had hypotension with SAP <80 mmHg. Peaks of catecholamine secretions were observed preferentially during peritoneal insufflation and tumor dissection (P < 0.05). A correlation was found between tumor size (mm) and the highest norepinephrine levels [r = 0.288, P = 0.015], and between hypertensive peaks (mmHg) and the highest norepinephrine levels [r = 0.45, P = 0.017]. No mortality was reported. The median [range] postoperative hospital stay was 4 [2–9] days. Conclusion: IV urapidil limits hypertensive and hypotensive peaks during PCC surgery, and corresponds to surgical imperatives allowing a short hospital stay, due to its “on–off” effect.
dc.language.isoENen_US
dc.rightsAttribution-NonCommercial-ShareAlike 3.0 United States
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/us/
dc.subject.enClinique
dc.subject.enAnesthesia
dc.subject.encatecholamine
dc.subject.enhypertension
dc.subject.enpheochromocytoma
dc.subject.enurapidil
dc.title.enPeri-operative management of pheochromocytoma with intravenous urapidil to prevent hemodynamic instability: A 17-year experience
dc.typeArticle de revueen_US
dc.identifier.doi10.4103/joacp.JOACP_71_18en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalJournal of Anaesthesiology Clinical Pharmacologyen_US
bordeaux.page49en_US
bordeaux.volume36en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.issue1en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-02971696
hal.version1
hal.date.transferred2020-10-19T14:37:18Z
hal.exporttrue
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