Cargando…

Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery

INTRODUCTION: Oral 5-aminolevulinic acid (5-ALA) is often used for photodynamic diagnosis-assisted glioma or bladder tumor surgery. 5-ALA affects blood pressure (BP). In fact, hypotension is a well-known adverse effect of 5-ALA in urology. However, information regarding 5-ALA-induced hemodynamic cha...

Descripción completa

Detalles Bibliográficos
Autores principales: Shiratori, Tohru, Hotta, Kunihisa, Satoh, Masaaki, Sato, Atsushi, Kamigaito, Takayuki, Kiuchi, Chiaki, Tanaka, Ryusuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japan Medical Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580708/
https://www.ncbi.nlm.nih.gov/pubmed/34796292
http://dx.doi.org/10.31662/jmaj.2021-0092
_version_ 1784596658892308480
author Shiratori, Tohru
Hotta, Kunihisa
Satoh, Masaaki
Sato, Atsushi
Kamigaito, Takayuki
Kiuchi, Chiaki
Tanaka, Ryusuke
author_facet Shiratori, Tohru
Hotta, Kunihisa
Satoh, Masaaki
Sato, Atsushi
Kamigaito, Takayuki
Kiuchi, Chiaki
Tanaka, Ryusuke
author_sort Shiratori, Tohru
collection PubMed
description INTRODUCTION: Oral 5-aminolevulinic acid (5-ALA) is often used for photodynamic diagnosis-assisted glioma or bladder tumor surgery. 5-ALA affects blood pressure (BP). In fact, hypotension is a well-known adverse effect of 5-ALA in urology. However, information regarding 5-ALA-induced hemodynamic changes in neurosurgery remains limited. Furthermore, the duration of hypotension and how 5-ALA affects the heart rate (HR) are yet to be determined. Thus, in this study, we aimed to elucidate 5-ALA-induced perioperative hemodynamic changes in neurosurgery and urological surgery by examining real-world data. METHODS: Consecutive patients who underwent neurosurgery (neurosurgery patients; 5-ALA-pretreated vs. non-pretreated [17 vs. 16], from January 2014 to March 2021) and urological surgery (urological surgery patients; 5-ALA-pretreated vs. non-pretreated [26 vs. 101], from August 2018 to September 2020) were enrolled. Differences in hemodynamics were evaluated using the linear mixed model. BP and HR in 5-ALA-pretreated patients were compared with those in non-pretreated patients. Differences in 5-ALA-induced preoperative BP changes were compared between the neurosurgery patients and urological surgery patients. RESULTS: 5-ALA scarcely affected the hemodynamics in neurosurgery patients, whereas 5-ALA-induced hemodynamic changes were clearly observed in urological surgery patients. Hemodynamic parameters were found to be not significantly different between 5-ALA-pretreated and non-pretreated neurosurgery patients. The preoperative, intraoperative, and postoperative BP in 5-ALA-pretreated urological surgery patients were significantly lower than those in the non-pretreated patients. Preoperatively, two 5-ALA-pretreated urological surgery patients had severe postural hypotension (systolic BP <50 mmHg), and one of them did not continue with the surgery because of prolonged severe hypotension. The BP in 5-ALA-pretreated urological surgery patients tended to be persistently lower for 9 h after 5-ALA pretreatment. The preoperative and postoperative HR values were higher in 5-ALA-pretreated urological surgery patients. Cumulative incidences of BP reduction and HR elevation were significantly higher in 5-ALA-pretreated urological surgery patients. The preoperative BP reduction in 5-ALA-pretreated urological surgery patients was significantly larger than that in neurosurgery patients. CONCLUSIONS: 5-ALA-induced hemodynamics may differ between neurosurgery patients and urological surgery patients. 5-ALA may affect BP for at least 9 h.
format Online
Article
Text
id pubmed-8580708
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Japan Medical Association
record_format MEDLINE/PubMed
spelling pubmed-85807082021-11-17 Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery Shiratori, Tohru Hotta, Kunihisa Satoh, Masaaki Sato, Atsushi Kamigaito, Takayuki Kiuchi, Chiaki Tanaka, Ryusuke JMA J Original Research Article INTRODUCTION: Oral 5-aminolevulinic acid (5-ALA) is often used for photodynamic diagnosis-assisted glioma or bladder tumor surgery. 5-ALA affects blood pressure (BP). In fact, hypotension is a well-known adverse effect of 5-ALA in urology. However, information regarding 5-ALA-induced hemodynamic changes in neurosurgery remains limited. Furthermore, the duration of hypotension and how 5-ALA affects the heart rate (HR) are yet to be determined. Thus, in this study, we aimed to elucidate 5-ALA-induced perioperative hemodynamic changes in neurosurgery and urological surgery by examining real-world data. METHODS: Consecutive patients who underwent neurosurgery (neurosurgery patients; 5-ALA-pretreated vs. non-pretreated [17 vs. 16], from January 2014 to March 2021) and urological surgery (urological surgery patients; 5-ALA-pretreated vs. non-pretreated [26 vs. 101], from August 2018 to September 2020) were enrolled. Differences in hemodynamics were evaluated using the linear mixed model. BP and HR in 5-ALA-pretreated patients were compared with those in non-pretreated patients. Differences in 5-ALA-induced preoperative BP changes were compared between the neurosurgery patients and urological surgery patients. RESULTS: 5-ALA scarcely affected the hemodynamics in neurosurgery patients, whereas 5-ALA-induced hemodynamic changes were clearly observed in urological surgery patients. Hemodynamic parameters were found to be not significantly different between 5-ALA-pretreated and non-pretreated neurosurgery patients. The preoperative, intraoperative, and postoperative BP in 5-ALA-pretreated urological surgery patients were significantly lower than those in the non-pretreated patients. Preoperatively, two 5-ALA-pretreated urological surgery patients had severe postural hypotension (systolic BP <50 mmHg), and one of them did not continue with the surgery because of prolonged severe hypotension. The BP in 5-ALA-pretreated urological surgery patients tended to be persistently lower for 9 h after 5-ALA pretreatment. The preoperative and postoperative HR values were higher in 5-ALA-pretreated urological surgery patients. Cumulative incidences of BP reduction and HR elevation were significantly higher in 5-ALA-pretreated urological surgery patients. The preoperative BP reduction in 5-ALA-pretreated urological surgery patients was significantly larger than that in neurosurgery patients. CONCLUSIONS: 5-ALA-induced hemodynamics may differ between neurosurgery patients and urological surgery patients. 5-ALA may affect BP for at least 9 h. Japan Medical Association 2021-09-27 2021-10-15 /pmc/articles/PMC8580708/ /pubmed/34796292 http://dx.doi.org/10.31662/jmaj.2021-0092 Text en Copyright © Japan Medical Association https://creativecommons.org/licenses/by/4.0/JMA Journal is an Open Access journal distributed under the Creative Commons Attribution 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Original Research Article
Shiratori, Tohru
Hotta, Kunihisa
Satoh, Masaaki
Sato, Atsushi
Kamigaito, Takayuki
Kiuchi, Chiaki
Tanaka, Ryusuke
Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery
title Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery
title_full Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery
title_fullStr Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery
title_full_unstemmed Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery
title_short Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery
title_sort differences in 5-aminolevulinic acid-induced hemodynamic changes between patients undergoing neurosurgery and urological surgery
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8580708/
https://www.ncbi.nlm.nih.gov/pubmed/34796292
http://dx.doi.org/10.31662/jmaj.2021-0092
work_keys_str_mv AT shiratoritohru differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery
AT hottakunihisa differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery
AT satohmasaaki differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery
AT satoatsushi differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery
AT kamigaitotakayuki differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery
AT kiuchichiaki differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery
AT tanakaryusuke differencesin5aminolevulinicacidinducedhemodynamicchangesbetweenpatientsundergoingneurosurgeryandurologicalsurgery