Have a personal or library account? Click to login
Pharmacological management of intraoperative hypertensive crises in pheochromocytoma: A narrative review of esmolol, nicardipine, and sodium nitroprusside Cover

Pharmacological management of intraoperative hypertensive crises in pheochromocytoma: A narrative review of esmolol, nicardipine, and sodium nitroprusside

Open Access
|Sep 2025

References

  1. StatPearls. StatPearls [Internet]. Nih.gov. StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430685/
  2. Pacak K. Preoperative Management of the Pheochromocytoma Patient. The Journal of Clinical Endocrinology & Metabolism. 2007 Nov;92(11):4069-79.
  3. Xu X, Kaindl J, Clark MJ, Hübner H, Hirata K, Sunahara RK, et al. Binding pathway determines norepinephrine selectivity for the human β1AR over β2AR. Cell Research [Internet]. 2020 Oct 22;31(5):569-79. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089101/
  4. Nazari MA, Rosenblum JS, Haigney MC, Rosing DR, Pacak K. Pathophysiology and Acute Management of Tachyarrhythmias in Pheochromocytoma: JACC Review Topic of the Week. Journal of the American College of Cardiology [Internet]. 2020 Jul 28;76(4):451-64. Available from: https://pubmed.ncbi.nlm.nih.gov/32703516/
  5. Gupta PK, Marwaha B. Pheochromocytoma [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK589700/
  6. Tuncel M, Ram VCS. Hypertensive Emergencies. American Journal of Cardiovascular Drugs [Internet]. 2003 Jan 1 [cited 2022 Jan 4];3(1):21-31. Available from: https://link.springer.com/article/10.2165%2F00129784-200303010-00003
  7. Manger W. The Protean Manifestations of Pheochromocytoma. Hormone and Metabolic Research. 2009 Feb 25;41(09):658-63.
  8. Ito Y, Fuimoto Y, Obara T. The role of epinephrine, norepinephrine, and dopamine in blood pressure disturbances in patients with pheochromocytoma. World Journal of Surgery. 1992 Jul;16(4):759-63.
  9. O’Rourke MF, Staessen JA, Vlachopoulos C, Duprez D, Plante GE. Clinical applications of arterial stiffness; definitions and reference values. American Journal of Hypertension [Internet]. 2002 May 1 [cited 2021 May 6];15(5):426-44. Available from: https://pubmed.ncbi.nlm.nih.gov/12022246/
  10. Y-Hassan S, Falhammar H. Cardiovascular Manifestations and Complications of Pheochromocytomas and Paragangliomas. Journal of Clinical Medicine. 2020 Jul 30;9(8):2435.
  11. Ramachandran R, Rewari V. Current perioperative management of pheochromocytomas. Indian Journal of Urology : IJU : Journal of the Urological Society of India [Internet]. 2017;33(1):19-25. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5264186/
  12. Tait A, Howell SJ. Preoperative hypertension: perioperative implications and management. BJA Education. 2021 Nov;21(11):426-32.
  13. Krishna B, Khurana DK, Kohli S, Sharma KR, Gandhi R. Perioperative hemodynamic management in surgery for phaeochromocytoma. The Indian Anaesthetists Forum. 2023 Jan;24(1):11-20.
  14. Kamath AS, Singh K. Perioperative Management of Pheochromocytoma [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK589634/
  15. Mamilla D, Araque K, Brofferio A, Gonzales M, Sullivan J, Nilubol N, et al. Postoperative Management in Patients with Pheochromocytoma and Paraganglioma. Cancers. 2019 Jul 3;11(7):936.
  16. Patel D. Surgical approach to patients with pheochromocytoma. Gland Surgery. 2020 Feb;9(1):32-42.
  17. Aleksandr Pevtsov, Fredlund KL. Esmolol [Internet]. Nih.gov. StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK518965/
  18. Lentschener C, Gaujoux S, Tesniere A, Dousset B. Point of controversy: perioperative care of patients undergoing pheochromocytoma removal-time for a reappraisal? Eur J Endocrinol. 2011.
  19. Esmolol (Intravenous Route) Side Effects - Mayo Clinic [Internet]. www.mayoclinic.org. Available from: https://www.mayoclinic.org/drugs-supplements/esmolol-intravenous-route/side-effects/drg-20071133
  20. Godoroja-Diarto D, Moldovan C, Tomulescu V. Actualities in the anaesthetic management of pheochromocytoma/paraganglioma. Acta Endocrinol (Buchar). 2021 Oct-Dec;17(4):557-64. doi: 10.4183/ aeb.2021.557. PMID: 35747860; PMCID: PMC9206166.
  21. Gage CB, Toney-Butler TJ. Dose Calculation [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430836/
  22. Konjety P, Chakole V. Esmolol’s Role in Hemodynamic Management During Pheochromocytoma Surgery: A Comprehensive Review. Cureus. 2024 Jun 6;
  23. Sorkin EM, Clissold SP. Nicardipine. Drugs. 1987 Apr;33(4):296-345.
  24. Pepine CJ. Intravenous nicardipine: cardiovascular effects and clinical relevance. Clin Ther. 1988;10(3):316-25. PMID: 3078910
  25. Kinney MA, Warner ME, vanHeerden JA, et al. Perianesthetic risks and outcomes of pheochromocytoma and paraganglioma resection. Anesth Analg. 2000;90(5):1054-62
  26. Proye C, Thevenin D, Cecat P, Petillot P, Carnaille B, Verin P, et al. Exclusive use of calcium channel blockers in preoperative and intraoperative control of pheochromocytomas: hemodynamics and free catecholamine assays in ten consecutive patients. Surgery. 1989 Dec;106(6):1149-54. PMID: 2588118.
  27. Peppard WJ, Peppard SR, Somberg L. Optimizing drug therapy in the surgical intensive care unit. Surg Clin North Am. 2012;92(6):1573-620. doi: 10.1016/j.suc.2012.08.011
  28. Kinney MA, Narr BJ, Warner MA. Perioperative management of pheochromocytoma. J Cardiothorac Vasc Anesth. 2002;16(4):435-40.
  29. Roizen MF, Horrigan RW, Vaterlaus SA, et al. A prospective randomized trial of four anesthetic techniques for resection of pheochromocytoma. Anesthesiology. 1982;56(5):398-403.
  30. Tinker John H, Michenfelder John D. Sodium Nitroprusside. Anesthesiology. 1976 Sep 1;45(3):340-52.
  31. Holme MR, Sharman T. Sodium Nitroprusside [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557487/
DOI: https://doi.org/10.2478/amma-2025-0029 | Journal eISSN: 2668-7763 | Journal ISSN: 2668-7755
Language: English
Page range: 173 - 181
Submitted on: Mar 25, 2025
|
Accepted on: Jun 9, 2025
|
Published on: Sep 18, 2025
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2025 Gabriela Salari, Mihaela Butiulca, published by University of Medicine, Pharmacy, Science and Technology of Targu Mures
This work is licensed under the Creative Commons Attribution 4.0 License.