PMID- 23158177
OWN - NLM
STAT- MEDLINE
DCOM- 20130122
LR  - 20131121
IS  - 1532-7361 (Electronic)
IS  - 0039-6060 (Linking)
VI  - 152
IP  - 6
DP  - 2012 Dec
TI  - Utility of oral nicardipine and magnesium sulfate infusion during preparation and 
      resection of pheochromocytomas.
PG  - 1027-36
LID - S0039-6060(12)00476-X [pii]
LID - 10.1016/j.surg.2012.08.023 [doi]
AB  - BACKGROUND: Calcium channel blockade with nicardipine (NC) is an alternative to 
      phenoxybenzamine (PB) preparation for resection of a pheochromocytoma. 
      Intraoperative magnesium sulfate infusion (+MgSO(4)) 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 
      MgSO(4) 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 
      MgSO(4) 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 -MgSO(4) 
      (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 +MgSO(4) versus -MgSO(4) 
      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.
CI  - Copyright (c) 2012 Mosby, Inc. All rights reserved.
FAU - Siddiqi, Hasan K
AU  - Siddiqi HK
AD  - Division of Endocrine Surgery, Department of Surgery, University of Michigan, Ann 
      Arbor, MI 48109-0331, USA.
FAU - Yang, Hui-yu
AU  - Yang HY
FAU - Laird, Amanda M
AU  - Laird AM
FAU - Fox, Amy C
AU  - Fox AC
FAU - Doherty, Gerard M
AU  - Doherty GM
FAU - Miller, Barbra S
AU  - Miller BS
FAU - Gauger, Paul G
AU  - Gauger PG
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surgery
JT  - Surgery
JID - 0417347
RN  - 0 (Adrenergic alpha-Antagonists)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Calcium Channel Blockers)
RN  - 0TTZ664R7Z (Phenoxybenzamine)
RN  - 7487-88-9 (Magnesium Sulfate)
RN  - CZ5312222S (Nicardipine)
SB  - IM
MH  - Administration, Oral
MH  - Adrenal Gland Neoplasms/physiopathology/*surgery
MH  - Adrenergic alpha-Antagonists/administration & dosage
MH  - Adult
MH  - Aged
MH  - Antihypertensive Agents/administration & dosage
MH  - Blood Pressure
MH  - Calcium Channel Blockers/*administration & dosage
MH  - Female
MH  - Humans
MH  - Infusions, Intravenous
MH  - *Intraoperative Care
MH  - Magnesium Sulfate/*administration & dosage
MH  - Male
MH  - Middle Aged
MH  - Nicardipine/*administration & dosage
MH  - Phenoxybenzamine/administration & dosage
MH  - Pheochromocytoma/physiopathology/*surgery
MH  - *Preoperative Care
MH  - Young Adult
EDAT- 2012/11/20 06:00
MHDA- 2013/01/23 06:00
CRDT- 2012/11/20 06:00
PHST- 2012/03/02 00:00 [received]
PHST- 2012/08/16 00:00 [accepted]
PHST- 2012/11/20 06:00 [entrez]
PHST- 2012/11/20 06:00 [pubmed]
PHST- 2013/01/23 06:00 [medline]
AID - S0039-6060(12)00476-X [pii]
AID - 10.1016/j.surg.2012.08.023 [doi]
PST - ppublish
SO  - Surgery. 2012 Dec;152(6):1027-36. doi: 10.1016/j.surg.2012.08.023.