Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas

Hasan K. Siddiqi, Hui Yu Yang, Amanda M. Laird, Amy C. Fox, Gerard M. Doherty, Barbra S. Miller, Paul G. Gauger

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background: Calcium channel blockade with nicardipine (NC) is an alternative to phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. Intraoperative magnesium sulfate infusion (+MgSO4) is often used for its cardiovascular stabilizing properties. We hypothesized that preparation with NC would be similar clinically to PB for resection of a pheochromocytoma, and MgSO4 infusion would not affect intraoperative stability. Methods: This retrospective review included 64 patients undergoing resections of a pheochromocytoma from 2003 to 2011. PB or NC was used preoperatively, with MgSO4 use distributed equally in the population. Pre-, intra-, and postoperative hemodynamics and outcomes were compared. Results: There was no difference in NC (n = 7) versus PB (n = 57) or +MgSO 4 (n = 33) versus -MgSO4 (n = 31) groups for demographics with the exception of age. The NC group had smaller median tumor size and lesser plasma baseline levels of normetanephrine than the PB group, but subgroup analysis of all neoplasms <3.0 cm revealed no differences. Pre-, intra- and postoperative hemodynamic stability and outcomes were similar for NC versus PB analyses as well as the +MgSO4 versus -MgSO4 groups. Conclusion: NC use may be an equivalent alternative to PB in preoperative preparation, especially for smaller pheochromocytomas. Intraoperative MgSO 4 use does not seem to have a substantive effect on hemodynamic stability.

Original languageEnglish (US)
Pages (from-to)1027-1036
Number of pages10
JournalSurgery (United States)
Volume152
Issue number6
DOIs
StatePublished - Dec 2012
Externally publishedYes

Fingerprint

Nicardipine
Phenoxybenzamine
Magnesium Sulfate
Pheochromocytoma
Hemodynamics
Normetanephrine
Calcium Channels
Neoplasms
Demography
Population

ASJC Scopus subject areas

  • Surgery

Cite this

Siddiqi, H. K., Yang, H. Y., Laird, A. M., Fox, A. C., Doherty, G. M., Miller, B. S., & Gauger, P. G. (2012). Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas. Surgery (United States), 152(6), 1027-1036. https://doi.org/10.1016/j.surg.2012.08.023

Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas. / Siddiqi, Hasan K.; Yang, Hui Yu; Laird, Amanda M.; Fox, Amy C.; Doherty, Gerard M.; Miller, Barbra S.; Gauger, Paul G.

In: Surgery (United States), Vol. 152, No. 6, 12.2012, p. 1027-1036.

Research output: Contribution to journalArticle

Siddiqi, HK, Yang, HY, Laird, AM, Fox, AC, Doherty, GM, Miller, BS & Gauger, PG 2012, 'Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas', Surgery (United States), vol. 152, no. 6, pp. 1027-1036. https://doi.org/10.1016/j.surg.2012.08.023
Siddiqi, Hasan K. ; Yang, Hui Yu ; Laird, Amanda M. ; Fox, Amy C. ; Doherty, Gerard M. ; Miller, Barbra S. ; Gauger, Paul G. / Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas. In: Surgery (United States). 2012 ; Vol. 152, No. 6. pp. 1027-1036.
@article{9799cfaca6d346e3961f6cd2fbbc0214,
title = "Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas",
abstract = "Background: Calcium channel blockade with nicardipine (NC) is an alternative to phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. Intraoperative magnesium sulfate infusion (+MgSO4) is often used for its cardiovascular stabilizing properties. We hypothesized that preparation with NC would be similar clinically to PB for resection of a pheochromocytoma, and MgSO4 infusion would not affect intraoperative stability. Methods: This retrospective review included 64 patients undergoing resections of a pheochromocytoma from 2003 to 2011. PB or NC was used preoperatively, with MgSO4 use distributed equally in the population. Pre-, intra-, and postoperative hemodynamics and outcomes were compared. Results: There was no difference in NC (n = 7) versus PB (n = 57) or +MgSO 4 (n = 33) versus -MgSO4 (n = 31) groups for demographics with the exception of age. The NC group had smaller median tumor size and lesser plasma baseline levels of normetanephrine than the PB group, but subgroup analysis of all neoplasms <3.0 cm revealed no differences. Pre-, intra- and postoperative hemodynamic stability and outcomes were similar for NC versus PB analyses as well as the +MgSO4 versus -MgSO4 groups. Conclusion: NC use may be an equivalent alternative to PB in preoperative preparation, especially for smaller pheochromocytomas. Intraoperative MgSO 4 use does not seem to have a substantive effect on hemodynamic stability.",
author = "Siddiqi, {Hasan K.} and Yang, {Hui Yu} and Laird, {Amanda M.} and Fox, {Amy C.} and Doherty, {Gerard M.} and Miller, {Barbra S.} and Gauger, {Paul G.}",
year = "2012",
month = "12",
doi = "10.1016/j.surg.2012.08.023",
language = "English (US)",
volume = "152",
pages = "1027--1036",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Utility of oral nicardipine and magnesium sulfate infusion during preparation and resection of pheochromocytomas

AU - Siddiqi, Hasan K.

AU - Yang, Hui Yu

AU - Laird, Amanda M.

AU - Fox, Amy C.

AU - Doherty, Gerard M.

AU - Miller, Barbra S.

AU - Gauger, Paul G.

PY - 2012/12

Y1 - 2012/12

N2 - Background: Calcium channel blockade with nicardipine (NC) is an alternative to phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. Intraoperative magnesium sulfate infusion (+MgSO4) is often used for its cardiovascular stabilizing properties. We hypothesized that preparation with NC would be similar clinically to PB for resection of a pheochromocytoma, and MgSO4 infusion would not affect intraoperative stability. Methods: This retrospective review included 64 patients undergoing resections of a pheochromocytoma from 2003 to 2011. PB or NC was used preoperatively, with MgSO4 use distributed equally in the population. Pre-, intra-, and postoperative hemodynamics and outcomes were compared. Results: There was no difference in NC (n = 7) versus PB (n = 57) or +MgSO 4 (n = 33) versus -MgSO4 (n = 31) groups for demographics with the exception of age. The NC group had smaller median tumor size and lesser plasma baseline levels of normetanephrine than the PB group, but subgroup analysis of all neoplasms <3.0 cm revealed no differences. Pre-, intra- and postoperative hemodynamic stability and outcomes were similar for NC versus PB analyses as well as the +MgSO4 versus -MgSO4 groups. Conclusion: NC use may be an equivalent alternative to PB in preoperative preparation, especially for smaller pheochromocytomas. Intraoperative MgSO 4 use does not seem to have a substantive effect on hemodynamic stability.

AB - Background: Calcium channel blockade with nicardipine (NC) is an alternative to phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. Intraoperative magnesium sulfate infusion (+MgSO4) is often used for its cardiovascular stabilizing properties. We hypothesized that preparation with NC would be similar clinically to PB for resection of a pheochromocytoma, and MgSO4 infusion would not affect intraoperative stability. Methods: This retrospective review included 64 patients undergoing resections of a pheochromocytoma from 2003 to 2011. PB or NC was used preoperatively, with MgSO4 use distributed equally in the population. Pre-, intra-, and postoperative hemodynamics and outcomes were compared. Results: There was no difference in NC (n = 7) versus PB (n = 57) or +MgSO 4 (n = 33) versus -MgSO4 (n = 31) groups for demographics with the exception of age. The NC group had smaller median tumor size and lesser plasma baseline levels of normetanephrine than the PB group, but subgroup analysis of all neoplasms <3.0 cm revealed no differences. Pre-, intra- and postoperative hemodynamic stability and outcomes were similar for NC versus PB analyses as well as the +MgSO4 versus -MgSO4 groups. Conclusion: NC use may be an equivalent alternative to PB in preoperative preparation, especially for smaller pheochromocytomas. Intraoperative MgSO 4 use does not seem to have a substantive effect on hemodynamic stability.

UR - http://www.scopus.com/inward/record.url?scp=84869470743&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84869470743&partnerID=8YFLogxK

U2 - 10.1016/j.surg.2012.08.023

DO - 10.1016/j.surg.2012.08.023

M3 - Article

C2 - 23158177

AN - SCOPUS:84869470743

VL - 152

SP - 1027

EP - 1036

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 6

ER -