PROPRANOLOL IN THE MANAGEMENT OF HEMANGIOMA: DOSAGE, DURATION, ADVERSE EFFECTS, AND OUTCOMES — A CROSS-SECTIONAL STUDY AT A TERTIARY CARE HOSPITAL IN PAKISTAN

BACKGROUND: Infantile hemangiomas are the most common benign vascular tumors in neonates. They usually appear in the first week after birth and are often left alone. However, some hemangiomas proliferate, which can cause complications such as pain, bleeding, ulceration, or functional impairments. In such cases, treatment is needed. Propranolol, a non-selective beta-blocker, has been found as a first-line therapy in treating these hemangiomas by making them shrink faster and with fewer side effects. OBJECTIVE: To evaluate the effectiveness of propranolol therapy in infantile hemangiomas by assessing the appropriate dosage and its effect on lesion size. To identify and analyze the adverse effects and associated complications related to propranolol treatment in infants with hemangiomas. METHODOLOGY: 186 patients were included with proven hemangiomas that required treatment. Our study began with giving patients 1 mg/kg/day of propranolol, which increased to 3 mg/kg/day over seven days during patient assessment. The healthcare team controlled patients' heart health for three to six months when doctors adjusted daily medicine doses. The outcome measures were the reduction in large tissue size and regression and the identification of treatment side effects. RESULTS: Findings revealed that 164 (88%) patients experienced significant lesion softening while 142(76%) reported substantial size reduction in the first month of propranolol therapy (p<0.001). The healing process of ulcerated hemangiomas led to complete recovery in 164 (88%) of patient cases within the third-month timeframe. By the third month, hemangiomas were causing functional impairments (e.g., obstructed vision or airway), and improvement was noted; further adverse side effects were also resolved spontaneously. CONCLUSION: Propranolol represents a safe and effective therapy for infantile hemangiomas. Propranolol successfully treats infantile hemangiomas owing to its ability to shrink lesions quickly and eliminate associated complications with low side effects. KEYWORDS: Adverse effects, beta-blocker, clinical outcomes, hemangioma, propranolol, regression, vascular tumors.