For pheochromocytoma and sympathetic paraganglioma (PPGL), surgery can be used as a curative treatment; however, the life-threatening risk of perioperative hemodynamic instability (HI) presents challenges. This study aimed to analyze the incidence and predictive factors of perioperative HI. The electronic medical records of 114 consecutive patients who underwent surgery for PPGLs at our institution were retrospectively reviewed. HI was defined as one or more episodes of systolic blood pressure > 200 mmHg or mean blood pressure < 60 mmHg during surgery. The factors predictive of perioperative HI were determined using both univariate and multivariate analyses. Intraoperative HI occurred in 79 (69.3%) patients. In multivariate analysis, α-adrenergic receptor blocker duration (days) (odds ratio, 1.015; 95% confidence interval, 1.001–1.029) was a predictor for intraoperative HI. Postoperative hypotension occurred in 36 (31.6%) patients. Higher urine epinephrine levels, and greater preoperative highest heart rate (HR) were predictive factors for postoperative hypotension in PPGL patients. Caution should be taken in perioperative management for PPGL, especially with long duration of α-adrenergic receptor blocker use, higher urine epinephrine levels, and greater preoperative highest HR.

对于嗜铬细胞瘤和交感神经副神经节瘤（PPGL），手术可作为根治性治疗；然而，围手术期血流动力学不稳定 (HI) 危及生命的风险带来了挑战。本研究旨在分析围手术期 HI 的发生率和预测因素。对在我们机构接受 PPGL 手术的 114 名连续患者的电子病历进行了回顾性审查。HI 定义为手术期间收缩压 > 200 mmHg 或平均血压 < 60 mmHg 的一次或多次发作。使用单变量和多变量分析确定围手术期 HI 的预测因素。79 名 (69.3%) 患者发生了术中 HI。在多变量分析中，α-肾上腺素能受体阻滞剂持续时间（天）（优势比，1.015；95% 置信区间，1.001–1。029) 是术中 HI 的预测因子。36 名（31.6%）患者出现术后低血压。较高的尿肾上腺素水平和较高的术前最高心率 (HR) 是 PPGL 患者术后低血压的预测因素。PPGL 的围手术期管理应谨慎，尤其是长期使用 α-肾上腺素能受体阻滞剂、尿肾上腺素水平较高和术前最高 HR 较高时。