{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:35:58Z","timestamp":1787070958651,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 3","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n Phenoxybenzamine (PBZ), a long-acting \u03b1-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.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To evaluate the safety and efficacy of a PBZ-based vasoplegic strategy during cardiopulmonary bypass (CPB) in pediatric open-heart surgeries.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jpbs.jpbs_868_25","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T19:00:29Z","timestamp":1757358029000},"page":"S2135-S2137","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Phenoxybenzamine: Old Wine in a Bright New Bottle-Taming the wild side of Phenoxybenzamine"],"prefix":"10.4103","volume":"17","author":[{"given":"R. Benedict","family":"Raj","sequence":"first","affiliation":[{"name":"Department of Paediatric Cardiology and Cardiac Surgery, Children\u2019s Heart Institute, Aster Ramesh Hospitals, Vijayawada, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinath Reddy","family":"Narahari","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology and Cardiac Surgery, Children\u2019s Heart Institute, Aster Ramesh Hospitals, Vijayawada, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasudev","family":"Vemala","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology and Cardiac Surgery, Children\u2019s Heart Institute, Aster Ramesh Hospitals, Vijayawada, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotiprakash","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Paediatric Cardiology and Cardiac Surgery, Children\u2019s Heart Institute, Aster Ramesh Hospitals, Vijayawada, Andhra Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"R1-20250930","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1067\/mtc.2001.113747","article-title":"Pulmonary vascular resistance after cardiopulmonary bypass in infants:Effect on postoperative recovery","volume":"121","author":"Schulze-Neick","year":"2001","journal-title":"J Thorac Cardiovasc Surg"},{"key":"R2-20250930","first-page":"274","article-title":"Combination of phenoxybenzamine and nitroglycerin:Effective control of pulmonary artery pressures in children undergoing cardiac surgery","volume":"19","author":"Kiran","year":"2005","journal-title":"J CardiothoracVascAnesth"},{"key":"R3-20250930","doi-asserted-by":"crossref","first-page":"11","DOI":"10.4103\/jpcs.jpcs_42_16","article-title":"Alpha blockers:A relook at phenoxybenzamine","volume":"3","author":"Das","year":"2017","journal-title":"J Pract Cardiovasc Sci"},{"key":"R4-20250930","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1053\/j.jvca.2004.11.010","article-title":"Comparison of Phenoxybenzamine to Sodium Nitroprusside in Infants Undergoing Surgery","volume":"19","author":"Motta","year":"2005","journal-title":"J Cardiothoracic Vasc Anesth"},{"key":"R5-20250930","doi-asserted-by":"crossref","first-page":"577","DOI":"10.4103\/0971-9784.166473","article-title":"Role of phenoxybenzamine in perioperative clinical practice","volume":"18","author":"Das","year":"2015","journal-title":"Ann Card Anaesth"},{"key":"R6-20250930","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jclinane.2007.09.006","article-title":"The hemodynamic effects of phenoxybenzamine in neonates, infants, and children","volume":"20","author":"Mossad","year":"2008","journal-title":"J Clin Anesth"},{"key":"R7-20250930","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1053\/j.jvca.2017.07.007","article-title":"Vasodilator agents in pediatric cardiac surgery with cardiopulmonary bypass","volume":"32","author":"Nicolau","year":"2018","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R8-20250930","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1053\/j.jvca.2005.07.034","article-title":"Combination of low-dose phenoxybenzamine and sodium nitroprusside in children undergoing cardiac surgery","volume":"20","author":"Kiran","year":"2006","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R9-20250930","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2165\/00019053-199201020-00006","article-title":"Quality of life evaluation of antihypertensive drugs","volume":"1","author":"Bulpitt","year":"1992","journal-title":"Pharmacoeconomics"},{"key":"R10-20250930","first-page":"314","article-title":"The application of phenoxybenzamine in open heart surgery using cardiopulmonary bypass","volume":"17","author":"Sakauchi","year":"1976","journal-title":"J Cardiovasc Surg (Torino)"}],"container-title":["Journal of Pharmacy and Bioallied Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_868_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:39:35Z","timestamp":1787067575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jpbs.jpbs_868_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":10,"journal-issue":{"issue":"Suppl 3","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jpbs.jpbs_868_25","relation":{},"ISSN":["0976-4879","0975-7406"],"issn-type":[{"value":"0976-4879","type":"print"},{"value":"0975-7406","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-04-30","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}