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Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma

BACKGROUND: Anesthesia management of pheochromocytoma excision surgery is associated with severe hemodynamic fluctuations. The objective of this study is to compare the number of hypertensive crisis requiring sodium nitroprusside (SNP) administration between the groups treated with magnesium (Mg)-de...

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Autores principales: Sivrikoz, Nükhet, Turhan, Özlem, Yavru, Hacer Ayşen, Altun, Demet, İşcan, Yalın, Sormaz, İsmail Cem, Sungur, Zerrin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277350/
https://www.ncbi.nlm.nih.gov/pubmed/36282168
http://dx.doi.org/10.14744/tjtes.2022.92672
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author Sivrikoz, Nükhet
Turhan, Özlem
Yavru, Hacer Ayşen
Altun, Demet
İşcan, Yalın
Sormaz, İsmail Cem
Sungur, Zerrin
author_facet Sivrikoz, Nükhet
Turhan, Özlem
Yavru, Hacer Ayşen
Altun, Demet
İşcan, Yalın
Sormaz, İsmail Cem
Sungur, Zerrin
author_sort Sivrikoz, Nükhet
collection PubMed
description BACKGROUND: Anesthesia management of pheochromocytoma excision surgery is associated with severe hemodynamic fluctuations. The objective of this study is to compare the number of hypertensive crisis requiring sodium nitroprusside (SNP) administration between the groups treated with magnesium (Mg)-dexmedetomidine (Dex) and conventional group in pheochromocytoma. METHODS: This retrospective cohort study included patients who underwent pheochromocytoma surgery between 2011 and 2020. Patients were examined into two groups: 1-Conventional group (GC) included patients who were operated between 2011 and 2015 under standard anesthesia care and who did not receive perioperative additional medication. 2- Mg-Dex therapy group (GMD) comprised the patients who were operated between 2015 and 2020 and who had received 300 mg Mg per oral daily 1 week before the surgery and Mg-Dex infusion intraoperatively. Blood pressure, heart rate (HR), and SNP requirement were recorded throughout surgery as well as demographics and operative data. Hypertensive crisis was defined as systolic blood pressure (SBP) >180 mmHg, and tachycardia was defined as HR >110 bpm. RESULTS: A total of 78 patients’ data were analyzed from 108 patients’ documentary. (38 in GC, 40 in GMD) SNP requirement was significantly higher in GC (39.5%) comparing GMD (7.5%) (p=0.001). SBPs during tumor manipulation period were statistically higher in GC than in GMD at 10(th), 15(th), 20(th), 25(th), 30(th), and 35(th) min. HR values were significantly higher in GC compared to GMD at 10(th) and 15(th) min of tumor manipulation period (p<0.05). CONCLUSION: Combination of Mg-Dex seems to be an alternative therapy for reducing vasodilator requirement in perioperative management of pheochromocytoma.
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spelling pubmed-102773502023-06-20 Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma Sivrikoz, Nükhet Turhan, Özlem Yavru, Hacer Ayşen Altun, Demet İşcan, Yalın Sormaz, İsmail Cem Sungur, Zerrin Ulus Travma Acil Cerrahi Derg Original Article BACKGROUND: Anesthesia management of pheochromocytoma excision surgery is associated with severe hemodynamic fluctuations. The objective of this study is to compare the number of hypertensive crisis requiring sodium nitroprusside (SNP) administration between the groups treated with magnesium (Mg)-dexmedetomidine (Dex) and conventional group in pheochromocytoma. METHODS: This retrospective cohort study included patients who underwent pheochromocytoma surgery between 2011 and 2020. Patients were examined into two groups: 1-Conventional group (GC) included patients who were operated between 2011 and 2015 under standard anesthesia care and who did not receive perioperative additional medication. 2- Mg-Dex therapy group (GMD) comprised the patients who were operated between 2015 and 2020 and who had received 300 mg Mg per oral daily 1 week before the surgery and Mg-Dex infusion intraoperatively. Blood pressure, heart rate (HR), and SNP requirement were recorded throughout surgery as well as demographics and operative data. Hypertensive crisis was defined as systolic blood pressure (SBP) >180 mmHg, and tachycardia was defined as HR >110 bpm. RESULTS: A total of 78 patients’ data were analyzed from 108 patients’ documentary. (38 in GC, 40 in GMD) SNP requirement was significantly higher in GC (39.5%) comparing GMD (7.5%) (p=0.001). SBPs during tumor manipulation period were statistically higher in GC than in GMD at 10(th), 15(th), 20(th), 25(th), 30(th), and 35(th) min. HR values were significantly higher in GC compared to GMD at 10(th) and 15(th) min of tumor manipulation period (p<0.05). CONCLUSION: Combination of Mg-Dex seems to be an alternative therapy for reducing vasodilator requirement in perioperative management of pheochromocytoma. Kare Publishing 2022-11-01 /pmc/articles/PMC10277350/ /pubmed/36282168 http://dx.doi.org/10.14744/tjtes.2022.92672 Text en Copyright © 2022 Turkish Journal of Trauma and Emergency Surgery https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Article
Sivrikoz, Nükhet
Turhan, Özlem
Yavru, Hacer Ayşen
Altun, Demet
İşcan, Yalın
Sormaz, İsmail Cem
Sungur, Zerrin
Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
title Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
title_full Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
title_fullStr Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
title_full_unstemmed Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
title_short Magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
title_sort magnesium and dexmedetomidine combination reduces sodium nitroprusside requirement in laparoscopic pheochromocytoma
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277350/
https://www.ncbi.nlm.nih.gov/pubmed/36282168
http://dx.doi.org/10.14744/tjtes.2022.92672
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