Parenteral Manual


Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Sympathetic inhibitor
Original Date: 
October 2007
  • Regional sympathetic blockade for the treatment of reflex sympathetic dystrophy syndrome
Reconstitution and Stability: 
  • Available as a 10 mg/mL clear colourless solution
  • Protect from light
  • Use immediately after diluting



-Solutions Compatible: 0.9% NaCl

-Additives/Above Cassette Compatible: heparin, lidocaine

-Y-site Compatible: no information

Incompatible:  not information



(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct NO
IV Intermittent Infusion

YES, physician must be present ,  BP monitoring

Usual dilution:  0.4 - 0.8 mg/mL

Infusion time: 15 minutes                                  

IV Continuous Infusion NO





(For neonatal dosages, refer to Neonatal IV Drug Manual.)


  • Arm : 10-20 mg
  • Leg:  20-30 mg
  • Dose and volume of injection may be reduced if the tourniquet is applied more distally on the limb

-can be given alone or combined with heparin:

  • 10-20 mg with heparin 500 international units qs 25 mL with NS
  • 20-30 mg with heparin 1,000 international units qs 50 mL with NS
Potential hazards of parenteral administration: 
  • Apnea
  • Hypotension or paradoxical hypertension
  • Transient exacerbation of pain on injection  -may be used with lidocaine 1-2mg/kg
  • Diarrhea
  • Hyperglycemia, fluid retention
  • Should be done by personnel experienced in the use of regional blocks
  • Monitor blood pressure
  • Infusion into regional vein, using tourniquet to limit systemic effect -slowly deflate to regulate release of unincorporated guanethidine
  • Contraindicated in patients with pheochromocytoma, heart block greater than first degree, congestive heart failure or malignant ventricular arrhythmias
  • DO NOT use concurrently with or within 1 week of MAO inhibitors

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