Shir Y, Cameron L B, Raja S N, Bourke D L
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, MD 21205.
Anesth Analg. 1993 May;76(5):1008-11. doi: 10.1213/00000539-199305000-00016.
The safety of intravenous (i.v.) infusion of large doses of phentolamine as an outpatient diagnostic tool for sympathetically maintained pain was studied retrospectively in 100 consecutive patients (73 females and 27 males) with chronic pain. All patients were pretreated with i.v. fluids followed, in most cases, by propranolol, 1-2 mg i.v. (n = 95). Ten minutes later the phentolamine infusion commenced, lasting for 20 min. In 90 patients, the dose of phentolamine was 35 mg. Two patients received 25 mg, and 8 patients received larger doses of 50-75 mg. No major complications occurred during or after the test, and only small changes in arterial blood pressure or heart rate were observed. All patients developed mild nasal stuffiness, but no decline in oxygen saturation was observed. Five patients developed one of the following minor complications for a brief duration, that resolved spontaneously: sinus tachycardia, premature ventricular beats, dizziness, or wheezing. We conclude that i.v. phentolamine administration is safe in patients with neuropathic pain.
对100例连续的慢性疼痛患者（73例女性和27例男性）进行回顾性研究，以评估大剂量酚妥拉明静脉输注作为门诊诊断交感神经维持性疼痛工具的安全性。所有患者均先静脉输注液体，多数情况下随后静脉注射1 - 2 mg普萘洛尔（n = 95）。10分钟后开始输注酚妥拉明，持续20分钟。90例患者的酚妥拉明剂量为35 mg。2例患者接受25 mg，8例患者接受50 - 75 mg的较大剂量。测试期间或之后未发生重大并发症，仅观察到动脉血压或心率有微小变化。所有患者均出现轻度鼻塞，但未观察到氧饱和度下降。5例患者在短时间内出现以下轻微并发症之一，且均自行缓解：窦性心动过速、室性早搏、头晕或喘息。我们得出结论，静脉注射酚妥拉明对神经性疼痛患者是安全的。
