R. Benedict Raj, Srinath Reddy Narahari, Vasudev Vemala, Jyotiprakash Reddy
Aster Ramesh Hospitals.
India
Journal of Pharmacy and BioAllied Sciences
J Pharm Bioall Sci 2025; 17 (Suppl 3): S2135-S2137
DOI: 10.4103/jpbs.jpbs_868_25
Abstract
Background: Phenoxybenzamine (PBZ), a long-acting α-blocker, was once widely used in pediatric cardiac surgeries but fell out of favor due to concerns about systemic hypotension. In the context of developing countries and resource-limited settings, PBZ may offer a cost-effective and safe alternative when used in a controlled protocol.
Objective: To evaluate the safety and efficacy of a PBZ-based vasoplegic strategy during cardiopulmonary bypass (CPB) in pediatric open-heart surgeries.
Materials and methods: A prospective observational study was conducted between 2015 and 2020 at a tertiary care cardiac center. A total of 520 pediatric patients undergoing open-heart surgery with CPB received PBZ as the primary vasodilator in combination with low-dose adrenaline. Hemodynamic data, ICU outcomes, and incidence of postoperative complications were analyzed.
Results: The protocol achieved stable intraoperative perfusion without the need for additional vasopressors. Most patients were extubated on the same day, and the incidence of pulmonary arterial hypertension crisis was negligible (one case). Mortality was limited to 2.7%, and postoperative hypotension was effectively managed with fluid and adrenaline support.
Conclusion: PBZ, when used in a structured intraoperative protocol, offers a safe, economical, and effective strategy for pediatric cardiac surgeries, especially in settings with limited access to newer vasoplegic agents.
Category
Class I. Pulmonary Hypertension Associated with Congenital Cardiovascular Disease
Medical Therapy. Efficacy or Lack of Efficacy
Medical Therapy. Adverse Effects or Lack of Adverse Effects
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: Yes