Treatment of shock and prevention of ischemic necrosis with levarterenol-phentolamine mixtures.

ISCHEMIC NECROSIS resultinig from accidental extravasation of levarterenol (Levophed) in patients in shock can be prevented by local injection of 5 or 10 mg. of the anti-adrenergic drug phentolamine (Regitine).'4 This method is not effective when vasoconstriction has existed for several hours and irreversible tissue damage has occurred. Preliminary observatioins suggest that inmediate protection can be secured by adding phentolamilie to the flask of levarterenol.5 6 In rabbits, as little as 2.5 mg./L. of phentolamine antagoniizes the necrotizing effect of solutions containiing 8, 16, and 32 mg./L. of levarterenol.5 In 5 normotensive patients, 5 to 40 mg./L. of phentolamiine did not diminish the pressor effect of levarterenol. Similar observations were made in 5 patients in shock.6 The purpose of this paper is to evaluate the routine use of levarterenol-phentolamine mixtures in treatment of 68 cases of shock.