TY - JOUR
T1 - Perianesthetic risks and outcomes of pheochromocytoma and paraganglioma resection
AU - Kinney, Michelle A.O.
AU - Warner, Mary E.
AU - Van Heerden, Jon A.
AU - Horlocker, Terese T.
AU - Young, William F.
AU - Schroeder, Darrell R.
AU - Maxson, Pamela M.
AU - Warner, Mark A.
N1 - Funding Information:
This work was supported by the Mayo Foundation.
PY - 2000
Y1 - 2000
N2 - Pheochromocytomas and paragangliomas are often surgically curable. However, resection of these tumors can be life threatening. We undertook this study to determine the frequency of, and risk factors for, perioperative complications in patients undergoing resection of pheochromocytoma or paraganglioma. We retrospectively reviewed the medical records of patients during 1983-1996 who underwent surgical resection of catecholamine-secreting pheochromocytoma or paraganglioma. Preoperative risk factors, adverse intraoperative events, and complications occurring in the 30 days after operation were recorded. Blood pressures were collected from manual records. The ranked sum test and Fisher's exact test were used for analyses. Adverse perioperative events or complications occurred in 45 of 143 patients (31.5%; exact 95% confidence interval, 24.0% to 39.8%). Of these 45 patients, 41 experienced one or more adverse intraoperative events. The most common adverse event was sustained hypertension (36 patients). There were no perioperative deaths, myocardial infarctions, or cerebrovascular events. Preoperative factors univariately associated with adverse perioperative events included larger tumor size (P = 0.007), prolonged duration of anesthesia (P = 0.015), and increased levels of preoperative urinary catecholamines and catecholamine metabolites: vanillylmandelic acid (P = 0.019), metanephrines (P = 0.004), norepinephrine (P = 0.014), and epinephrine (P = 0.004). Despite premedication of most patients with phenoxybenzamine and a β-adrenergic blocker, varying degrees of intraoperative hemodynamic lability occurred.
AB - Pheochromocytomas and paragangliomas are often surgically curable. However, resection of these tumors can be life threatening. We undertook this study to determine the frequency of, and risk factors for, perioperative complications in patients undergoing resection of pheochromocytoma or paraganglioma. We retrospectively reviewed the medical records of patients during 1983-1996 who underwent surgical resection of catecholamine-secreting pheochromocytoma or paraganglioma. Preoperative risk factors, adverse intraoperative events, and complications occurring in the 30 days after operation were recorded. Blood pressures were collected from manual records. The ranked sum test and Fisher's exact test were used for analyses. Adverse perioperative events or complications occurred in 45 of 143 patients (31.5%; exact 95% confidence interval, 24.0% to 39.8%). Of these 45 patients, 41 experienced one or more adverse intraoperative events. The most common adverse event was sustained hypertension (36 patients). There were no perioperative deaths, myocardial infarctions, or cerebrovascular events. Preoperative factors univariately associated with adverse perioperative events included larger tumor size (P = 0.007), prolonged duration of anesthesia (P = 0.015), and increased levels of preoperative urinary catecholamines and catecholamine metabolites: vanillylmandelic acid (P = 0.019), metanephrines (P = 0.004), norepinephrine (P = 0.014), and epinephrine (P = 0.004). Despite premedication of most patients with phenoxybenzamine and a β-adrenergic blocker, varying degrees of intraoperative hemodynamic lability occurred.
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U2 - 10.1213/00000539-200011000-00013
DO - 10.1213/00000539-200011000-00013
M3 - Article
C2 - 11049893
AN - SCOPUS:0033756973
SN - 0003-2999
VL - 91
SP - 1118
EP - 1123
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 5
ER -