[Laparoscopic adrenalectomy for pheochromocytoma. Perioperative blockade with urapidil].

OBJECTIVE

To investigate the effects of coeliosurgery by catecholamine assays and the use of urapidil in the management of phaeochromocytoma.

STUDY DESIGN

Prospective cohort study.

PATIENTS

Nine consecutive patients from April 1997 to April 2001.

METHODS

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.

RESULTS

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.

CONCLUSION

Perioperative alpha 1 blockade by urapidil enables an effective and easy control of acute preoperative haemodynamic changes.