Tauzin-Fin P, Krol-Houdek M C, Gosse P, Ballanger P
Département d'anesthésie-réanimation III, hôpital Pellegrin-Tondu, 5, place Amélie Raba-Léon, 33076 Bordeaux, France.
Ann Fr Anesth Reanim. 2002 Jun;21(6):464-70. doi: 10.1016/s0750-7658(02)00657-3.
To investigate the effects of coeliosurgery by catecholamine assays and the use of urapidil in the management of phaeochromocytoma.
Prospective cohort study.
Nine consecutive patients from April 1997 to April 2001.
Urapidil (250 mg.j-1) was administered by continuous intravenous infusion three days before surgery and continued throughout anaesthesia. Plasma catecholamine concentrations were measured before surgery, after induction of anaesthesia, during insufflation, after adrenalectomy and in the recovery room. Haemodynamic disorders were treated by nicardipine +/- esmolol bolus doses.
Creation of pneumoperitoneum and adrenal gland manipulations resulted in significant catecholamine releases associated with hypertension in five and eight patients respectively. Preventive urapidil use enabled easy control of blood pressure variations by additive antihypertensive drugs.
Perioperative alpha 1 blockade by urapidil enables an effective and easy control of acute preoperative haemodynamic changes.
通过儿茶酚胺测定研究腔镜手术的效果以及乌拉地尔在嗜铬细胞瘤治疗中的应用。
前瞻性队列研究。
1997年4月至2001年4月连续纳入的9例患者。
术前三天持续静脉输注乌拉地尔（250mg·j-1），并在整个麻醉过程中持续使用。于术前、麻醉诱导后、气腹期间、肾上腺切除术后及恢复室测定血浆儿茶酚胺浓度。血流动力学紊乱采用尼卡地平加/减艾司洛尔静脉推注剂量进行治疗。
建立气腹和肾上腺操作分别导致5例和8例患者儿茶酚胺显著释放并伴有高血压。预防性使用乌拉地尔可通过加用降压药物轻松控制血压变化。
围手术期使用乌拉地尔进行α1受体阻滞可有效且轻松地控制术前急性血流动力学变化。
