回顾性评估酚苄明预处理对嗜铬细胞瘤犬术中心血管变量的影响。

Retrospective evaluation of the influence of phenoxybenzamine pretreatment on intraoperative cardiovascular variables in dogs with pheochromocytoma.

作者信息

Willette Craig, Bini Gianluca, Traverson Marine, Liptak Julius M, Hollenbeck Danielle, Maxwell Elizabeth A, de Mello Souza Carlos H, Wustefeld-Janssens Brandan, Selmic Laura

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, USA (Willette); Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA (Bini, Selmic); Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA (Traverson); Capital City Specialty & Emergency Animal Hospital, Ottawa, Ontario (Liptak); College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA (Hollenbeck); Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA (Maxwell, de Mello Souza); College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA (Wustefeld-Janssens).

出版信息

Can Vet J. 2024 Dec;65(12):1293-1301.

PMID:39649740

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11618959/

Abstract

OBJECTIVE

To compare cardiovascular outcomes in dogs undergoing adrenalectomy for pheochromocytoma with and without phenoxybenzamine pretreatment.

ANIMALS

A total of 65 medical records from dogs at 5 veterinary hospitals.

PROCEDURE

Records from January 2004 to December 2021 were evaluated for systolic, mean, and diastolic arterial pressures; numbers of hypertensive and hypotensive episodes; highest and lowest systolic arterial pressure differences; dose and duration of phenoxybenzamine; and presence of intraoperative arrhythmias. Phenoxybenzamine-pretreated dogs (Group PT, = 33) and dogs not receiving phenoxybenzamine (Group N, = 31) were compared. The Shapiro-Wilk test was used to test for normality, Student's -test was used for normally distributed data, and Fisher's exact test was used for ordinal and categorical data. Multivariable logistic regression was used to assess effect of pretreatment with phenoxybenzamine on occurrence of hypotension and hypertension, allowing for adjustment for confounding variables ( < 0.05).

RESULTS

Median (range) phenoxybenzamine dose was 0.46 (0.08 to 2.0) mg/kg, PO, q12h. Peak systolic and mean arterial pressures, lowest systolic and mean arterial pressures, duration of hypertension, duration of sinus tachycardia, number of hypotensive episodes, and duration of hypotension were not different between groups. More hypertensive episodes ( = 0.01) and anesthetic events involving hypertension ( = 0.02) were recorded in Group PT than in Group N.

CONCLUSION

In dogs undergoing adrenalectomy for pheochromocytoma, phenoxybenzamine pretreatment as administered did not offer any cardiovascular benefits based on the measured variables, and may be associated with more intraoperative hypertensive episodes.

CLINICAL RELEVANCE

Intraoperative changes in cardiovascular variables are prevalent in dogs with pheochromocytoma undergoing adrenalectomy. Further evaluation of pretreatment with phenoxybenzamine is needed to determine its role in these cases.

摘要

目的

比较接受嗜铬细胞瘤肾上腺切除术的犬在使用与未使用酚苄明预处理情况下的心血管结局。

动物

来自5家兽医医院的65只犬的医疗记录。

过程

评估2004年1月至2021年12月的记录，包括收缩压、平均动脉压和舒张压；高血压和低血压发作次数；最高和最低收缩压差值；酚苄明的剂量和持续时间；以及术中心律失常情况。比较接受酚苄明预处理的犬（PT组，n = 33）和未接受酚苄明的犬（N组，n = 31）。采用夏皮罗-威尔克检验来检验数据是否呈正态分布，对于正态分布的数据使用学生t检验，对于有序和分类数据使用费舍尔精确检验。使用多变量逻辑回归来评估酚苄明预处理对低血压和高血压发生的影响，并对混杂变量进行校正（P < 0.05）。

结果

酚苄明的中位（范围）剂量为0.46（0.08至2.0）mg/kg，口服，每12小时一次。两组之间的收缩压峰值和平均动脉压、最低收缩压和平均动脉压、高血压持续时间、窦性心动过速持续时间、低血压发作次数以及低血压持续时间均无差异。PT组记录到的高血压发作次数（P = 0.01）和涉及高血压的麻醉事件（P = 0.02）比N组更多。