To induce ischaemia and haemostasis at the site of an operation. It may be used with general anaesthetics which are usually not compatible with adrenaline; e.g. halothane, without fear of precipitating cardiac arrhythmias.
Usually 5 IU is diluted in 30 mL of physio- logical saline [max. dose for tissue infiltration is 5 IU]. Gynaecological surgery and laparoto- mies, more dilute solutions, e.g. 5 IU in 50 or 60 mL physiological saline are used. For ENT surgery more concentrated solutions, 5 IU in 20 mL physiological saline may be used.
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It is a synthetic polypeptide with a potent and specific constrictor effect on micro- circulation and veins which is equal to, if not greater than, that of vasopressin; it also has antidiuretic activity, but this is weak by compari- son with vasopressin. Topical application or infiltration leads within 10 minutes to local ischaemia which usually lasts for 1 to 2 hours without causing reactive hyperaemia.
Some absorption may occur from local application leading to systemic vasoconstriction. A rise in blood pressure may occur in some patients. Caution is therefore indicated in conditions in which a rise in blood pressure would be medically undesirable. Anginal symptoms may be precipitated in patients with ischaemic heart disease.
Coronary heart disease; severe hypertension; toxaemia of pregnancy; advanced arteriosclerosis; epilepsy.
It is generally well tolerated; facial or general pallor; a rise (or occasionally fall) in blood pressure, cardiac arrhythmias, anginal pain, increased perspiration and increased bowel motility.