Selective α1-adrenoceptor antagonist (controlled release tablets) in preoperative management of pheochromocytoma.
The objective of this article is to evaluate the efficacy of Doxazosin Mesylate Controlled Release Tablets for preoperative treatment of patients with pheochromocytoma. Between 2003 and 2008, 67 patients with confirmed diagnoses of pheochromocytoma were enrolled in this study. According to the drug used in preoperative management, patients were divided into two groups: Doxazosin Mesylate pretreatment group (n=36) and Phenoxybenzamine pretreatment group (n=31). Surgery was performed only in patients who met the optimal preoperative condition. The hematocrit decreased significantly (P<0.001) after antiadrenergic therapy in patients pretreated with phenoxybenzamine or doxazosin. There was no significant difference between the fluid intakes during operation in both groups. The systolic arterial pressures both before and after induction of anesthesia were all significantly higher in the doxazosin patients than in the phenoxybenzamine group (P<0.05). After tumor removed, the lowest systolic arterial pressure was significantly higher in doxazosin group than in phenoxybenzamine group (P<0.05). The fluctuation of systolic arterial pressure during operation was more stable in doxazosin group than in phenoxybenzamine group (P<0.05). Doxazosin mesylate controlled release tablet was as effective as phenoxybenzamine in preoperative volume expansion. Although phenoxybenzamine provided better arterial pressure control, patients pretreated with DOX experienced more stable perioperative hemodynamic changes, shorter preoperative management periods and more simple medication.
Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China. zyyyhyq@126.com
Yu
Y
Zhu
Hong-chao
HC
He
Ting-wei
TW
Su
Yu-xuan
YX
Wu
Wei-qing
WQ
Wang
Ju-ping
JP
Zhao
Zhoujun
Z
Shen
Chong-yu
CY
Zhang
Wen-bin
WB
Rui
Wen-long
WL
Zhou
Fu-kang
FK
Sun
Guang
G
Ning
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D058668:Adrenergic alpha-1 Receptor Antagonists / Q000008:administration & dosage*; D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D003692:Delayed-Action Preparations; D017292:Doxazosin / Q000008:administration & dosage*; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010643:Phenoxybenzamine / Q000008:administration & dosage; D010673:Pheochromocytoma / Q000601:surgery*; D011300:Preoperative Care; D055815:Young Adult
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D003692:Delayed-Action Preparations; D010643:Phenoxybenzamine; D017292:Doxazosin