Comparision Between Phenoxybenzamine And Doxazosin Of The Effect In The Preoperotive Preparation Of Pheochromocytoma

Objective:To investigate the difference between two kind of alpha blockers:phenoxybenzamine and doxazosin in pheochromocytoma preoperative preparation especially for the influence of hemodynamics.Methods:Retrospectively analysis 40 patients diagnosed with pheochromocytoma after the operation in China-Japan union hospital of Jilin university from October 2013 to January 2016. Patients are divided into two groups according to the preoperative use of drugs.Group1(Group PXB,n=19):Preoperative use of phenoxybenzamine,30-60mg/d, 2-3 oral. Group 2(Group DOX, n=21): Preoperative use of doxazosin controlled-release tablets, oral 4-8mg/d, 1 times. Compare two groups of hemodynamic alterations of perioperative period, drug onset time, arrhythmia occurrence probability of preparation before surgery, combined with calcium channel blockers and other side effects incidence.Result:1. In the preoperative preparation process of two groups patients, DOX group preoperative preparation time was significantly shorter in the PXB group(P<0.01).And in the preoperative preparation process, DOX group suffered less dizziness,palpitation, orthostatic hypotension and other side effects than the PXB group(P<0.01). DOX group need less beta blocker than that in PXB group(P<0.01).2. Two groups of patients got same BP before blood pressure drug control,and there is no significant difference between them of blood pressure and blood pressure at the onset of the peak(P > 0.05); systolic blood pressure difference before anesthesia:group DOX systolic blood pressure was significantly higher than PXB group( P<0.01). Anesthesia after induction of systolic blood pressure,:DOX group was significantly higher than that of group of PXB( P<0.01);When exploring the tumor and blood pressure of the two groups were increased, but there is no significant difference(P>0.05); after tumor resection, DOX group was significantly higher thanthat of group of PXB in systolic blood pressure, DOX groups during the operative blood pressure fluctuations is significantly less than that in the PXB group( P<0.01).No significant differences in systolic blood pressure after operation(P>0.05). PXB group need more crystalloid and colloid fluid intake to maintain stable blood pressure( P<0.01), no significant difference between the two sets of blood loss(P>0.05).Conclusion:1. The using of doxazosin mesylate controlled release tablets as pheochromocytoma preoperative preparation medicine receive less side effect and less preoperative preparation time compared with phenoxybenzamine2. Phenoxybenzamine as a preoperative preparation of drug control, the anti hypertensive effect is better than doxazosin mesylate controlled release tablets, but large fluctuations in blood pressure brings relatively higher operative risk3. Mesylate doxazosin controlled release tablets as preoperative medicine the antihypertensive effect is good,and the intraoperative blood pressure fluctuation is less. During operation,DOX group need consume less liquid. So, Mesylate Controlled Release Tabletscan can be used to replace phenoxybenzamine in the preopeartive preparation of pheochromocytoma.