BACKGROUND: Calcium channel blockade with nicardipine (NC) is an alternative to phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. Intraoperative magnesium sulfate infusion (+MgSO(4)) is often used for its cardiovascular stabilizing properties. We hypothesized that preparation with NC would be similar clinically to PB for resection of a pheochromocytoma, and MgSO(4) infusion would not affect intraoperative stability. METHODS: This retrospective review included 64 patients undergoing resections of a pheochromocytoma from 2003 to 2011. PB or NC was used preoperatively, with MgSO(4) use distributed equally in the population. Pre-, intra-, and postoperative hemodynamics and outcomes were compared. RESULTS: There was no difference in NC (n = 7) versus PB (n = 57) or +MgSO(4) (n = 33) versus -MgSO(4) (n = 31) groups for demographics with the exception of age. The NC group had smaller median tumor size and lesser plasma baseline levels of normetanephrine than the PB group, but subgroup analysis of all neoplasms <3.0 cm revealed no differences. Pre-, intra- and postoperative hemodynamic stability and outcomes were similar for NC versus PB analyses as well as the +MgSO(4) versus -MgSO(4) groups. CONCLUSION: NC use may be an equivalent alternative to PB in preoperative preparation, especially for smaller pheochromocytomas. Intraoperative MgSO(4) use does not seem to have a substantive effect on hemodynamic stability.
BACKGROUND: Calcium channel blockade with nicardipine (NC) is an alternative to phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. Intraoperative magnesium sulfate infusion (+MgSO(4)) is often used for its cardiovascular stabilizing properties. We hypothesized that preparation with NC would be similar clinically to PB for resection of a pheochromocytoma, and MgSO(4) infusion would not affect intraoperative stability. METHODS: This retrospective review included 64 patients undergoing resections of a pheochromocytoma from 2003 to 2011. PB or NC was used preoperatively, with MgSO(4) use distributed equally in the population. Pre-, intra-, and postoperative hemodynamics and outcomes were compared. RESULTS: There was no difference in NC (n = 7) versus PB (n = 57) or +MgSO(4) (n = 33) versus -MgSO(4) (n = 31) groups for demographics with the exception of age. The NC group had smaller median tumor size and lesser plasma baseline levels of normetanephrine than the PB group, but subgroup analysis of all neoplasms <3.0 cm revealed no differences. Pre-, intra- and postoperative hemodynamic stability and outcomes were similar for NC versus PB analyses as well as the +MgSO(4) versus -MgSO(4) groups. CONCLUSION:NC use may be an equivalent alternative to PB in preoperative preparation, especially for smaller pheochromocytomas. Intraoperative MgSO(4) use does not seem to have a substantive effect on hemodynamic stability.
Authors: Laurent Brunaud; Phi-Linh Nguyen-Thi; Eric Mirallie; Marco Raffaelli; Menno Vriens; Pierre-Etienne Theveniaud; Myriam Boutami; Brendan M Finnerty; Wessel M C M Vorselaars; Inne Borel Rinkes; Rocco Bellantone; Celestino Lombardi; Thomas Fahey; Rasa Zarnegar; Laurent Bresler Journal: Surg Endosc Date: 2015-06-20 Impact factor: 4.584
Authors: Henrique Vara Luiz; Mary Jane Tanchee; Maria G Pavlatou; Run Yu; Joan Nambuba; Katherine Wolf; Tamara Prodanov; Robert Wesley; Karen Adams; Tito Fojo; Karel Pacak Journal: Clin Endocrinol (Oxf) Date: 2016-04-15 Impact factor: 3.478
Authors: Alberto Mazza; Michela Armigliato; Maria Cristina Marzola; Laura Schiavon; Domenico Montemurro; Giorgio Vescovo; Marco Zuin; Sotirios Chondrogiannis; Roberta Ravenni; Giuseppe Opocher; Patrick M Colletti; Domenico Rubello Journal: Endocrine Date: 2013-07-02 Impact factor: 3.633