Hypotension caused by oral administration of 5-aminolevulinic acid persists after surgery in patients undergoing transurethral resection of bladder tumor under spinal anesthesia

Sato, Masami; Yanagisawa, Tsutomu; Minamino, Sonoko; Arai, Toshiyuki

doi:10.1186/s40981-020-00399-4

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…This may indicate that the effect of 5-ALA on hemodynamics was different between the neurosurgery patients and urological surgery patients. In our survey conducted in the urological surgery patients, 5-ALA-induced hypotension was clearly observed, which closely corroborates previous findings (17) , (19) . Figures 1a, b and c show that the hemodynamic changes in the 5-ALA-pretreated neurosurgery patients were similar to those in the non-pretreated patients.…”

Section: Discussionsupporting

confidence: 92%

“…Thus, anesthesia induction was in the middle of 5-ALA-induced hypotension, and 5-ALA had prolonged effects on hemodynamics. Although a previous study reported that the effect of 5-ALA lasted 2 h after TURBT (19) , few studies have examined the duration of the effects of 5-ALA on hemodynamics. In our postoperative management of the urological surgery patients, BP was not practically measured at night if the general condition was stable.…”

Section: Discussionmentioning

confidence: 99%

“…In severe cases, 5-ALA-induced hemodynamic changes occurred preoperatively and postoperatively persisted (12) , (13) , (14) . Reportedly, the real-world incidence of 5-ALA-induced hypotension was high in patients who underwent PDD-assisted urological surgery (15) , (16) , (17) , (18) , (19) . However, the cause of 5-ALA-induced hypotension remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery

Shiratori¹,

Hotta

Satoh

et al. 2021

JMA J

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery

Shiratori¹,

Hotta

Satoh

et al. 2021

JMA J

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“…If a patient is under general anesthesia, their BP may recover once they awaken. Spinal anesthesia also has a risk of severe hypotension [ 17 ], so it would be better to choose an anesthesia method that is best suited to managing hypotension.…”

Section: Discussionmentioning

confidence: 99%

Severe hypotension and postoperative cardiac arrest caused by 5-aminolevulinic acid: a case report

Miyazaki,

Taguchi,

Obata

et al. 2024

J Med Case Reports

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Background Although 5-aminolevulinic acid is useful for the photodynamic diagnosis of bladder tumors, it often causes severe intraoperative hypotension. We report a case of postoperative cardiac arrest in addition to severe intraoperative hypotension, probably owing to the use of 5-aminolevulinic acid. Case presentation An 81-year-old Japanese man was scheduled to undergo transurethral resection of bladder tumor. The patient took 5-aminolevulinic acid orally 2 hours before entering the operating room. After the induction of anesthesia, his blood pressure decreased to 47/33 mmHg. The patient’s hypotension did not improve even after noradrenaline was administered. After awakening from anesthesia, the patient’s systolic blood pressure increased to approximately 100 mmHg, but approximately 5 hours after returning to the ward, cardiac arrest occurred for approximately 12 seconds. Conclusion We experienced a case of postoperative cardiac arrest in a patient, probably owing to the use of 5-aminolevulinic acid. Although the cause of cardiac arrest is unknown, perioperative hemodynamic management must be carefully performed in patients taking 5-aminolevulinic acid.

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“…A new trial on NMIBC (NCT03597087) was initiated to investigate the impact of LAN on cancer recurrence. The oral drug 5-aminolevulinic acid used to help visualize tumors during TURBT was also found to cause hypotension, which in turn could impact surgical outcomes in terms of tumor recurrence [149].…”

Section: Impact Of Anti-hypertensive Drugs and Anesthetics On Bladder...mentioning

confidence: 99%

The Bladder Tumor Microenvironment Components That Modulate the Tumor and Impact Therapy

Patwardhan,

Mahendran

2023

IJMS

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The tumor microenvironment (TME) is complex and involves many different cell types that seemingly work together in helping cancer cells evade immune monitoring and survive therapy. The advent of single-cell sequencing has greatly increased our knowledge of the cell types present in the tumor microenvironment and their role in the developing cancer. This, coupled with clinical data showing that cancer development and the response to therapy may be influenced by drugs that indirectly influence the tumor environment, highlights the need to better understand how the cells present in the TME work together. This review looks at the different cell types (cancer cells, cancer stem cells, endothelial cells, pericytes, adipose cells, cancer-associated fibroblasts, and neuronal cells) in the bladder tumor microenvironment. Their impact on immune activation and on shaping the microenvironment are discussed as well as the effects of hypertensive drugs and anesthetics on bladder cancer.

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Hypotension caused by oral administration of 5-aminolevulinic acid persists after surgery in patients undergoing transurethral resection of bladder tumor under spinal anesthesia

Cited by 9 publications

References 5 publications

Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery

Differences in 5-Aminolevulinic Acid-Induced Hemodynamic Changes between Patients Undergoing Neurosurgery and Urological Surgery

Severe hypotension and postoperative cardiac arrest caused by 5-aminolevulinic acid: a case report

The Bladder Tumor Microenvironment Components That Modulate the Tumor and Impact Therapy

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