October - December 2016, Volume 12, Issue 4

Reinisch A, Holzer K, Bojunga J, Bechstein WO, Habbe N

Patients’ Safety and Feasibility of Intravenous Urapidil in the Pretreatment of Pheochromocytoma Patients in a Normal Ward Setting – an Analysis of 20 Consecutive Cases

Acta Endo (Buc) 2016, 12 (4): 475-480
doi: 10.4183/aeb.2016.475

Context. The intravenously administered selective α1 antagonist urapidil represents an alternative to phenoxybenzamine in the preoperative treatment of pheochromocytoma patients. Objective. The aim of the study was to investigate the blood pressure changes in pheochromocytoma patients with urapidil pretreatment with special regards to the need for interventions in order to estimate the safety of this treatment in a normal ward setting. Design. The medical records of all patients who underwent adrenalectomy for PCC were reviewed retrospectively. Systolic blood pressure values >180mmHg were defined as hypertensive episodes and systolic blood pressure values < 50mmHg as hypotensive episodes. Episodes of blood pressure instabilities were considered significant and recorded as intervention if they led to a direct action. Results. Twenty consecutive patients who received urapidil pretreatment were enrolled in this retrospective study. Preoperatively, a median of 9 blood pressure measurements per day have been performed on the ward. A total of 2 episodes of hypertension occurred, and 1 episode of hypotension has been recorded. In the period from 25-72 hours postoperatively the median number of blood pressure measurements was 5 per 24 hours. The blood pressure deviations led to a total of 3 interventions for hypertension in 1 (5%) patients and 5 interventions for hypotension in 3 (15%) patients. All interventions could be managed on the normal ward, without the need to transfer the patient to an ICU. Conclusions. Intravenous urapidil can safely be administered on a normal ward without putting patients at risk. Intensive monitoring beyond 24 hours postoperatively was not necessary, the blood pressure measurements during the shift on a normal ward were sufficient for maintaining patients’ safety.

Keywords: Pheochromocytoma, Urapidil, Adrenalectomy, Pretreatmen, patient safety

Correspondence: Nils Habbe MD, University Hospital Frankfurt, Department of General and Visceral Surgery, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany, E-mail: nils.habbe@kgu.de