Plum Michelle, Moukhachen Oussayma
P T. 2017 Sep;42(9):581-592.
Vasopressor extravasation is a rare adverse drug reaction that can lead to tissue damage, ischemia, and necrosis of the affected area when vasopressors are administered peripherally. Phentolamine, a nonselective, reversible alpha antagonist, is the current standard treatment for this adverse reaction, but it is often unavailable for use. This review seeks to synthesize the available data in order to recommend alternative pharmacological options for use when phentolamine is not available. After an extensive literature search, 16 publications were reviewed. A treatment algorithm was created that recommends a combination of subcutaneous terbutaline, a selective beta agonist, and topical nitroglycerin, an organic nitrate, for adults; and topical nitroglycerin monotherapy for children younger than 2 years of age. However, further research and case reports are required in order to establish a new standard of care for the treatment of vasopressor extravasation.
血管升压药外渗是一种罕见的药物不良反应，当外周给予血管升压药时，可导致受影响区域的组织损伤、缺血和坏死。酚妥拉明是一种非选择性、可逆性α拮抗剂，是目前治疗这种不良反应的标准方法，但它常常无法使用。本综述旨在综合现有数据，以便在酚妥拉明无法使用时推荐其他可用的药理学选择。经过广泛的文献检索，对16篇出版物进行了综述。创建了一种治疗方案，建议成人使用选择性β激动剂皮下注射特布他林和有机硝酸盐硝酸甘油联合治疗；2岁以下儿童使用硝酸甘油单一疗法局部治疗。然而，为了建立血管升压药外渗治疗的新护理标准，还需要进一步的研究和病例报告。
