International journal of urology : official journal of the Japanese Urological Association · 2025
Association Between Preoperative 5-Aminolevulinic Acid Administration Timing and Perioperative Hypotension.
СтатьяНазвание и аннотация: Перевод в очереди
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Hori Tomohiro, Nohara Takahiro, Kawahara Tetsuya, Nakagawa Ryunosuke, Fukuda Rie, Kamijima Taiki, Kano Hiroshi, Makino Tomoyuki, Naito Renato, Iwamoto Hiroaki, Yaegashi Hiroshi, Shigehara Kazuyoshi, Izumi Kouji, Mizokami Atsushi
Аннотация
OBJECTIVES: Photodynamic diagnosis-assisted transurethral resection of bladder tumors with oral 5-aminolevulinic acid administration improves tumor visibility but results in perioperative hypotension. In 2024, the recommended timing of 5-aminolevulinic acid administration was revised to enable oral intake 2-8 h preoperatively, thereby making it easier to adjust the timing of drug administration and surgery. This study aimed to investigate the association between the interval from 5-aminolevulinic acid administration to the start of surgery and perioperative blood pressure.
METHODS: We retrospectively analyzed 112 consecutive patients who underwent photodynamic diagnosis-assisted transurethral resection of bladder tumors from July 2022 to June 2024. Patients were categorized based on the time between oral 5-aminolevulinic acid administration and spinal or general anesthesia induction into the control (< 4 h) and extended time (≥ 4 h) groups. The perioperative blood pressure and severity of hypotension were compared between the two groups.
RESULTS: The extended time group comprised fewer cases of moderate to severe hypotension than the control group (38% and 61%, respectively; p = 0.039). Blood pressure was significantly higher at several time points intraoperatively in the extended time group. Further, the extended time group required fewer doses of vasopressor agents (p = 0.025).
CONCLUSIONS: An interval of more than 4 h from oral 5-aminolevulinic acid intake to anesthesia administration may reduce the risk of perioperative hypotension during photodynamic diagnosis-assisted transurethral resection of bladder tumors.
METHODS: We retrospectively analyzed 112 consecutive patients who underwent photodynamic diagnosis-assisted transurethral resection of bladder tumors from July 2022 to June 2024. Patients were categorized based on the time between oral 5-aminolevulinic acid administration and spinal or general anesthesia induction into the control (< 4 h) and extended time (≥ 4 h) groups. The perioperative blood pressure and severity of hypotension were compared between the two groups.
RESULTS: The extended time group comprised fewer cases of moderate to severe hypotension than the control group (38% and 61%, respectively; p = 0.039). Blood pressure was significantly higher at several time points intraoperatively in the extended time group. Further, the extended time group required fewer doses of vasopressor agents (p = 0.025).
CONCLUSIONS: An interval of more than 4 h from oral 5-aminolevulinic acid intake to anesthesia administration may reduce the risk of perioperative hypotension during photodynamic diagnosis-assisted transurethral resection of bladder tumors.