Reversal of Dopamine Extravasation Injury with Topical Nitroglycerin Ointment

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Abstract
Dopamine infusion has been associated with tissue necrosis from peripheral vasospasm1–8 and extravasation.5.9–14 The treatment of dopamine-induced vasospasm includes reduction or cessation of the dopamine, use of systemic intravenous chlorpromazine4 or nitroprusside,3 local tissue infiltration with phentolamine,5,12 and application of topical nitroglycerin.15,16 Treatment of dopamine and other vasoconstrictor extravasation injuries has included elevation and splinting12,13,17,18 and local infiltration of phentolamine5,8,9 or phentolamine plus hyalu-ronidase.19 These programs are not universally successful. This case report details what we feel is the first report of dopamine extravasation injury treated with topical nitroglycerin ointment.

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