[Laparoscopic adrenalectomy for pheochromocytoma. Perioperative blockade with urapidil].
OBJECTIVE
To investigate the effects of coeliosurgery by catecholamine assays and the use of urapidil in the management of phaeochromocytoma.


METHODS
Prospective cohort study.


METHODS
Nine consecutive patients from April 1997 to April 2001.


METHODS
Urapidil (250 mg.j-1) was administered by continuous intravenous infusion three days before surgery and continued throughout anaesthesia. Plasma catecholamine concentrations were measured before surgery, after induction of anaesthesia, during insufflation, after adrenalectomy and in the recovery room. Haemodynamic disorders were treated by nicardipine +/- esmolol bolus doses.


RESULTS
Creation of pneumoperitoneum and adrenal gland manipulations resulted in significant catecholamine releases associated with hypertension in five and eight patients respectively. Preventive urapidil use enabled easy control of blood pressure variations by additive antihypertensive drugs.


CONCLUSIONS
Perioperative alpha 1 blockade by urapidil enables an effective and easy control of acute preoperative haemodynamic changes.
Département d'anesthésie-réanimation III, hôpital Pellegrin-Tondu, 5, place Amélie Raba-Léon, 33076 Bordeaux, France. secretariat.ballanger@bu-u-bordeaux2.fr
P
P
Tauzin-Fin
M C
MC
Krol-Houdek
P
P
Gosse
P
P
Ballanger
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000758:Anesthesia; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002395:Catecholamines / Q000097:blood; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010673:Pheochromocytoma / Q000601:surgery*; D010879:Piperazines / Q000627:therapeutic use*; D011446:Prospective Studies
D000317:Adrenergic alpha-Antagonists; D000959:Antihypertensive Agents; D002395:Catecholamines; D010879:Piperazines; C015568:urapidil