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[Relationship between the Landiolol Dose and Urinary Catecholamine Metabolites in the Perioperative Management of Patients Undergoing Pheochromocytoma Resection].

BACKGROUND
The amount of urinary catecholamine metabolites (metanephrine and normetanephrine) excreted in 24 hours correlates with catecholamine secretion by pheochromocytoma in a day and is considered an indicator of the strength of its hormonal activity. We investigated the existence of a relationship between the landiolol dose and urinary catecholamine metabolites in the perioperative management of patients with pheochromocytoma.


METHODS
We retrospectively investigated the medical and anesthesia records of patients treated at University of Tsukuba Hospital between December 2007 and June 2012. Sixteen patients who underwent elective surgery for adrenal pheochromocytoma were divided into 2 groups according to their urinary catecholamine metabolites group A (higher amounts of urinary metanephrine adrenaline-dominated group) and group NA (higher amounts of urinary normetanephrine; noradrenaline-dominated group).


RESULTS
Each group included 8 patients. The total intraoperative landiolol dose was significantly higher in group A (46.8 ± 34.5 mg) than in group NA (13.8 ± 21.3 mg; P = 0.04). The landiolol dose was significantly associated with higher amounts of urinary metanephrine (R = 0.592 P = 0.0123).


CONCLUSIONS
High landiolol doses are required to treat tachycardia in the perioperative management of pheochromocytoma cases with higher urinary metanephrine during the preoperative period.