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Influence of Pre‐operative Treatment with Phenoxybenzamine on the Incidence of Adverse Cardiovascular Reactions during Anaesthesia and Surgery for Phaeochromocytoma
Author(s) -
Stenström G.,
Haljamäe H.,
Tisell L. E.
Publication year - 1985
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1985.tb02303.x
Subject(s) - medicine , phenoxybenzamine , anesthesia , evening , incidence (geometry) , adverse effect , blood pressure , surgery , blockade , perioperative , general anaesthesia , morning , propranolol , physics , receptor , astronomy , optics
The influence of pre‐operative treatment with the α‐adrenoceptor blocking agent, phenoxybenzamine, on the incidence of adverse cardiovascular reactions during anaesthesia and surgery for phaeochromocytoma was evaluated in a series of 62 patients. Fifty‐one of them received pre‐operative treatment with phenoxybenzamine and eight of these were also treated with β‐adrenoceptor blocking agents. The median final daily dose of phenoxybenzamine was 160 mg and the median period of treatment 23 days. The evening before surgery and in the early morning on the day of surgery, intravenous infusion of phenoxybenzamine was given to 42 of the patients. Eleven patients operated on between 1956 and 1963 received no specific preoperative treatment and served as a reference group. The α‐adrenoceptor blocking treatment resulted in a considerably smoother peroperative course, as evidenced by a statistically significant reduction in the incidence of excessive blood‐pressure variations. The blockade was not complete since 69% of the patients had systolic peaks > 175 mmHg during surgery. Pre‐operative blood transfusions did not significantly affect the incidence of hypotensive episodes. Pre‐operative β‐adrenoceptor blockade did not reduce the incidence of peroperative arrhythmia. On the basis of our experience, we recommend that all phaeochromocytoma patients be treated pre‐operatively with α‐adrenoceptor blocking agents.