All patients undergoing resection of a pheochromocytoma should receive preoperative pharmacologic therapy, which typically includes initiation of an α-blocker (eg, phenoxybenzamine) at least 10 days preoperatively. Once α-blockade is sustained, a ß-blocker (eg, propranolol) is typically initiated at least 3 days prior to surgery. In the absence of α-blockade, ß-blockade can exacerbate hypertension. Sodium nitroprusside is not used preoperatively in patients with adrenal incidentaloma in the absence of a hypertensive crisis.
- Phenoxybenzamine 10 days preoperatively followed by propranolol 3 days preoperatively.
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Seminars in Medical Practice
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