Preoperative Preparation With Selective versus Nonselective Alpha-Adrenoceptor Blockade for Pheochromocytomas and Paragangliomas: A Systematic Review and Updated Meta-Analysis
Authors' conclusion
Preoperative preparation of NAB was superior to SAB in controlling peak intraoperative hypertension and maintaining hemodynamic stability for patients with PPGL.
Study context
- Population
- Patients with PPGL undergoing surgical resection; databases searched up to August 2, 2025
- Participants
- 2,293 patients20 studies
- Comparison
- Nonselective alpha-blockers (NAB) vs selective alpha-blockers (SAB) for preoperative preparation
- Outcome
- Intraoperative haemodynamics
- Follow-up
- Intraoperative
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
NAB vs SABOdds ratio (95% CI)P value
Intraoperative hypertensive crisis
0.33(0.17–0.61)
P < 0.001NAB vs SABMD, mmHg (95% CI)P value
Maximum intraoperative systolic BP
−12.85(−18.11 to −7.60)
P < 0.001Minimum systolic BP; higher with NAB
2.02(0.53–3.51)
P = 0.008NAB vs SABMD (95% CI)P value
Hemodynamic instability score
−6.75(−13.59 to 0.08)
P = 0.05Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Intraoperative vasopressors required | 0.60 (0.39–0.92) | P = 0.02 | |
| Intraoperative vasodilators required | 0.50 (0.33–0.75) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
Other secondary outcomes
- No significant differences observed
Original publication
Preoperative Preparation With Selective versus Nonselective Alpha-Adrenoceptor Blockade for Pheochromocytomas and Paragangliomas: A Systematic Review and Updated Meta-Analysis. Endocr Pract. Published 11 May 2026. doi:10.
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