Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma.

Abstract

BACKGROUND:

Anesthesia management of pheochromocytoma excision surgery is associated with severe hemodynamic fluctuations. The objective of this study is to compare the number of hypertensive crisis requiring sodium nitroprusside (SNP) administration between the groups treated with magnesium (Mg)-dexmedetomidine (Dex) and conventional group in pheochromocytoma.

METHODS:

This retrospective cohort study included patients who underwent pheochromocytoma surgery between 2011 and 2020. Patients were examined into two groups: 1-Conventional group (GC) included patients who were operated between 2011 and 2015 under standard anesthesia care and who did not receive perioperative additional medication. 2- Mg-Dex therapy group (GMD) comprised the patients who were operated between 2015 and 2020 and who had received 300 mg Mg per oral daily 1 week before the surgery and Mg-Dex infusion intraoperatively. Blood pressure, heart rate (HR), and SNP requirement were recorded throughout surgery as well as demographics and operative data. Hypertensive crisis was defined as systolic blood pressure (SBP) >180 mmHg, and tachycardia was defined as HR >110 bpm.

RESULTS:

A total of 78 patients' data were analyzed from 108 patients' documentary. (38 in GC, 40 in GMD) SNP requirement was significantly higher in GC (39.5%) comparing GMD (7.5%) (p=0.001). SBPs during tumor manipulation period were statistically higher in GC than in GMD at 10th, 15th, 20th, 25th, 30th, and 35th min. HR values were significantly higher in GC compared to GMD at 10th and 15th min of tumor manipulation period (p<0.05).

CONCLUSION:

Combination of Mg-Dex seems to be an alternative therapy for reducing vasodilator requirement in perioperative management of pheochromocytoma.

• Authors: Nükhet Sivrikoz, Özlem Turhan, Hacer Ayşen Yavru, Demet Altun, Yalın Işcan, Ismail Cem Sormaz, Zerrin Sungur
• Journal: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES (Ulus Travma Acil Cerrahi Derg) Vol. 28 Issue 11 Pg. 1563-1569 (Nov 2022) ISSN: 1307-7945 [Electronic] Turkey
• Vernacular Title: Laparoskopik feokromositomada magnezyum ve deksmedetomidin kombinasyonu sodyum nitroprussid gereksinimini azaltır.
• PMID: 36282168 (Publication Type: Journal Article)

Chemical References

• Dexmedetomidine
• Nitroprusside
• Magnesium
• Vasodilator Agents

Topics

• Humans
• Pheochromocytoma (surgery, drug therapy)
• Dexmedetomidine (therapeutic use)
• Nitroprusside
• Magnesium
• Retrospective Studies
• Adrenal Gland Neoplasms (surgery, drug therapy)
• Laparoscopy
• Vasodilator Agents (therapeutic use)