Perioperative Blood Pressure Control in Pheochromocytoma: The Role of Intravenous Urapidil

Pheochromocytomas are rare tumors derived from chromaffin cells of neural crest origin in the adrenal medulla. These neoplasms typically synthesize and secrete catecholamines. Excessive secretion of catecholamines can lead to severe and potentially fatal hypertensive crises. Our study presents 2 cases where blood pressure control was achieved using intravenous urapidil infusion before and during pheochromocytoma surgery. Case 1 was a 54-year-old male patient who received preoperative doxazosin and nebivolol. Urapidil infusion was started at a dose of 5 mg per hour 72 hours before the surgery and titrated by 1 mg per hour to control blood pressure. The patient’s blood pressure remained stable during the intraoperative and postoperative periods. Case 2 was a 52-year-old female patient who received preoperative doxazosin and propranolol. Urapidil infusion was initiated 72 hours before the surgery, and blood pressure control was maintained before and after the operation. Considering both cases, urapidil may be a cost-effective alternative to phenoxybenzamine and phentolamine for optimizing blood pressure before and during pheochromocytoma surgery.