Perioperative medicine & outcomes
Omitting the Escalating Dosage of Alpha-adrenergic Blockade Before Pheochromocytoma Resection: Implementation of a Treatment Strategy in Discordance With Current Guidelines
Authors' conclusion
Our data suggest that adrenalectomy for pheochromocytoma employing a de-escalated preoperative α-blockade protocol is safe and results in a shorter hospital stay.
Study context
- Population
- Patients undergoing adrenalectomy for pheochromocytoma, 2015–2023of 102 patients
- Participants
- 82 patients
- Exposure
- De-escalated vs Dose-escalated
- De-escalatedn = 44
- Dose-escalatedn = 38reference
- Outcome
- Intraoperative hypertension (time-weighted average of systolic blood pressure (TWA-SBP) above 200 mm Hg)
Methodological detailssingle-institution, protocol implementation evaluation
- Single-institution
- Protocol implementation evaluation
Main finding
As reported in the abstract
TWA-SBP above 200 mm Hg
P = 0.073
Observational data: associations, not effects.
Secondary outcomes
Duration of postoperative continuous norepinephrine administration
P = 0.003
| Outcome | P value |
|---|---|
| Hospital stay | P < 0.001 |
Safety
Postoperative symptomatic hypotension
- Postoperative symptomatic hypotension: 34.2% versus 9.1% of patients (P =0.005)
Complications
- No significant differences in complication rates
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Omitting the Escalating Dosage of Alpha-adrenergic Blockade Before Pheochromocytoma Resection: Implementation of a Treatment Strategy in Discordance With Current Guidelines. Ann Surg. Published 6 August 2024. doi:10.
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