Stetson J B, Reading G P
Can Anaesth Soc J. 1977 Nov;24(6):727-33. doi: 10.1007/BF03006717.
Dopamine, dihydroxyphenylethylamine has three distinct actions depending on dosage. Low doses in the range of 1-2 mcg/kg/min result in vasodilatation. Medium doses of 2-10 mcg/kg/min increase cardiac output due to beta adrenergic action, while above 10 mcg/kg/min a potent vasoconstrictor effect predominates. Because of this last action great care must be used to avoid extravasation of infusions of dopamine directly into the tissue. Dopamine is a very useful agent but carries great potential to do local damage. Administration through a catheter placed into a large vein is recommended. Should extravasation occur, prompt infiltration of the area with phentolamine and a local anaesthetic, local cooling and regional sympathetic block may reduce the damage. The case is reported of a patient who suffered extensive necrosis in the forearm following local extravasation of dopamine.
多巴胺，即二羟基苯乙胺，根据剂量不同有三种不同作用。剂量在1 - 2微克/千克/分钟时会导致血管舒张。中等剂量2 - 10微克/千克/分钟因β肾上腺素能作用增加心输出量，而超过10微克/千克/分钟时则以强大的血管收缩作用为主导。由于这最后一种作用，必须格外小心以避免多巴胺输注液直接渗入组织。多巴胺是一种非常有用的药物，但有造成局部损伤的巨大潜在风险。建议通过置于大静脉的导管给药。若发生外渗，用酚妥拉明和局部麻醉剂迅速浸润该区域、局部冷敷及区域交感神经阻滞可能减轻损伤。本文报道了一例患者，其前臂在多巴胺局部外渗后发生广泛坏死。
