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Efficacy and Safety of Doxazosin for Perioperative Management of Patients with Pheochromocytoma
- Source :
- World Journal of Surgery. 26:1037-1042
- Publication Year :
- 2002
- Publisher :
- Springer Science and Business Media LLC, 2002.
-
Abstract
- Despite adverse side effects, phenoxybenzamine has been widely used for the preoperative management of patients with pheochromocytoma. Doxazosin, a specific a 1-adrenoceptor antagonist, has a pharmacologic profile more suited to controlling blood pressure in such patients. A sequential study of 35 patients with pheochromocytoma encompassed a definite and prescribed change in preoperative drug management from phenoxybenzamine to doxazosin. Hemodynamic, pharmacologic, and biochemical indicators of a- and b-adrenoceptor blockade were measured before, during, and after anesthesia and surgery in 8 patients pretreated with phenoxybenzamine and 27 patients pretreated with doxazosin. Doxazosin (2-16 mg/day) was as effective as phenoxybenzamine in controlling arterial pressure and heart rate before and during surgery, but doxazosin caused fewer undesirable side effects both before and after surgery. Following phenoxybenzamine therapy substantial a 1-adrenoceptor blockade, detected as a right shift of phenylephrine dose-response curves, persisted for more than 2 days postoperatively, whereas after doxazosin it was undetectable on the first postoperative day. Doxazosin provided safe, efficacious pre- and perioperative control of arterial pressure. In patients with predominantly norepinephrine-secreting tumors, pretreatment 24-hour urinary norepinephrine excretion gave an indication of the daily doxazosin requirement.
- Subjects :
- Adult
Male
Adolescent
Phenoxybenzamine
Adrenal Gland Neoplasms
Hemodynamics
Blood Pressure
Pheochromocytoma
urologic and male genital diseases
Perioperative Care
Norepinephrine
medicine
Doxazosin
Humans
Adverse effect
Adrenergic alpha-Antagonists
Aged
Dose-Response Relationship, Drug
business.industry
Perioperative
Middle Aged
medicine.disease
Treatment Outcome
Blood pressure
Anesthesia
Female
Surgery
business
Abdominal surgery
medicine.drug
Subjects
Details
- ISSN :
- 14322323 and 03642313
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- World Journal of Surgery
- Accession number :
- edsair.doi.dedup.....8c4df0c287d213b695e2dfa4efdad5d4
- Full Text :
- https://doi.org/10.1007/s00268-002-6667-z