A Meta Analysis On Compare The Effects Of Selective/Non-Selective Alpha-Blockers In The Perioperative Of Pheochromocytoma

Objectives:To systematically review the Effects of Selective/non-selective Alpha-blockers in The Perioperative of Pheochromocytoma.Methods:Databases including Pubmed,the Cochrane Library,CBM,Wanfang were electronically searched for Clinical control trials about comparing nonselective and selective alpha-blocker for pheochromocytoma before January 2019.According to the inclusion and exclusion criteria,two reviewers in dependently screened literature,extracted data and use RevMan5.3 software to perform meta-analysis.Results: Eight Clinical control trials involving 1017 patients were finally included.1).In preoperative preparation,compared with selective group,nonselectively blocked group had more side effects[OR=0.11,95%CI(0.03,0.39),p=0.0007].But for duration of alpha-blockade(P=0.78)and number of patients requiring Beta-blockers(p=0.93),there were no significant differences between the two group.2).During operation,compared with selective group,there was statistical difference in the non-selectively blocked group,in terms of maximum SBP[MD=-7.70,95%CI(-11.37,-4.02),P<0.0001],occurrence rate of transient SBP>200mmHg [OR=0.40,95%CI(0.17,0.96),P=0.04],hypotention[OR=0.31,95%CI(0.12,0.83),p=0.02],the non-selectively blocked group was lower.But there were no significant differences between the two group for miximum SBP(P=0.48)and occurrence rate of transient intraoperative SBP > 160 mm Hg(0.49).3).Postoperative indicators.Compared with selective group,non-selectively blocked group had lower postoperative maximum SBP [MD=-8.94,95%CI(-12.52,-5.36),P<0.00001].But for complication(p=0.78),length of stay(p=0.47),minimum SBP(P=0.51),mean SBP(P=0.30)and number of patients requiring vasopressors(p=0.05),there were no significant differences between the two group.Conclusions: Although the side effects of non-selective alpha blockers were more common than that of selective alpha blockers,non-selective alpha blockers had stronger antihypertensive effect,more stable BP fluctuation.There was no significant difference in preoperative preparation time,the need of beta blockers,postoperative complications,or length of hospital stay and so on.