Incidence of perioperative hypotension in patients undergoing transurethral resection of bladder tumor after oral 5-aminolevulinic acid administration: a retrospective multicenter cohort study.
5-Aminolevulinic acid
Hypotension
Transurethral resection of bladder tumor
Journal
Journal of anesthesia
ISSN: 1438-8359
Titre abrégé: J Anesth
Pays: Japan
ID NLM: 8905667
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
10
03
2023
accepted:
30
06
2023
medline:
5
10
2023
pubmed:
9
7
2023
entrez:
9
7
2023
Statut:
ppublish
Résumé
Tumors can be visualized using 5-Aminolevulinic acid hydrochloride (5-ALA) during transurethral resection of bladder tumors (TURBT). Hypotension is an adverse effect of 5-ALA; however, its incidence and morbidity rates are unknown. This study aimed to describe the incidence of perioperative hypotension and identify risk factors for hypotension among patients after 5-ALA administration in TURBT. This retrospective multicenter cohort study was conducted at three general hospitals in Japan. Adult patients who underwent elective TURBT after 5-ALA administration between April 2018 and August 2020 were included. The primary outcome was the incidence of perioperative hypotension (mean blood pressure < 65 mmHg). The secondary outcomes were the use of vasoactive agents and adverse events, including urgent intensive care unit (ICU) admission. Multivariate logistic regression analysis was performed to investigate risk factors of the incidence of intraoperative hypotension. The median age of 261 patients was 73 years. General anesthesia was induced in 252 patients. The intraoperative hypotension was observed in 246 (94.3%) patients. Three patients (1.1%) were urgently admitted to the ICU for continued vasoactive agent use after surgery. All three patients had renal dysfunction. Multivariate logistic regression analysis revealed that general anesthesia was significantly associated with intraoperative hypotension (adjusted odds ratio, 17.94; 95% confidence interval, 3.21-100.81). The incidence of hypotension in patients undergoing TURBT after 5-ALA administration was 94.3%. The incidence of urgent ICU admission with prolonged hypotension was 1.1% in all patients with renal dysfunction. General anesthesia was significantly associated with intraoperative hypotension.
Identifiants
pubmed: 37422859
doi: 10.1007/s00540-023-03222-3
pii: 10.1007/s00540-023-03222-3
doi:
Substances chimiques
Aminolevulinic Acid
88755TAZ87
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
703-713Informations de copyright
© 2023. The Author(s) under exclusive licence to Japanese Society of Anesthesiologists.
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