Preoperative Factors Associated with Intraoperative Maximum Arterial Pressures in Patients with Pheochromocytoma and Paraganglioma
| Author | Haruyuki Ohsugi | en |
| Author | Nae Takizawa | en |
| Author | Hidefumi Kinoshita | en |
| Orcid | Haruyuki Ohsugi [0000-0002-9878-6974] | en |
| Issued Date | 2022-07-31 | en |
| Abstract | Background: Surgery for pheochromocytoma and paraganglioma (PPGL) can lead to life-threatening complications, such as intraoperative hypertensive crises, even when adequate doses of preoperative α-receptor blockades are administered. Objectives: The aim of this study was to identify preoperative factors associated with intraoperative maximum arterial pressure (AP) in patients with PPGL. Methods: We retrospectively reviewed the cases of 61 PPGL patients who underwent surgical resection in our hospital between 2006 and 2020. The primary outcome was intraoperative maximum AP as a single index for continuous variables. Simple and multiple linear regression model were used for statistical analysis. Results: The median maximum systolic AP during surgery was 165 mmHg (interquartile range: 150 - 180 mmHg). Log24-h urinary-fractionated metanephrine (MN) and normetanephrine (NMN) was correlated with intraoperative maximum AP (R-squared = 0.218, P < 0.001). Multiple regression analyses showed that diabetes mellitus, one or more of the classic triad, and log24-h urinary-fractionated MN and NMN were independent factors associated with intraoperative maximum AP. Conclusions: Patients with PPGL accompanied by diabetes mellitus, one or more of the classic triad, and high log 24-h urinary-fractionated MN and NMN values may be at risk for hypertensive crises during surgery regardless of whether preoperative α-receptor blockades are used. Clinicians should manage these patients more carefully and effectively. | en |
| DOI | https://doi.org/10.5812/ijem-123114 | en |
| Keyword | Surgery | en |
| Keyword | Arterial Pressure | en |
| Keyword | Metanephrine | en |
| Keyword | Normetanephrine | en |
| Keyword | Paraganglioma | en |
| Keyword | Pheochromocytoma | en |
| Publisher | Brieflands | en |
| Title | Preoperative Factors Associated with Intraoperative Maximum Arterial Pressures in Patients with Pheochromocytoma and Paraganglioma | en |
| Type | Research Article | en |
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