Efficacy of Oral Nifedipine in the Treatment of Reflex Sympathetic Dystrophy

Prough, Donald S.; McLeskey, Charles H.; Poehling, Gary G.; Koman, L. Andrew; Weeks, Duke B.; Whitworth, Teresa; Semble, Elliott L.

doi:10.1097/00000542-198506000-00017

Cited by 83 publications

(11 citation statements)

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“…Oral nifedipine at doses increased weekly from 10 mg twice a day to 30 mg twice a day produced complete (7 cases), partial (2 cases) or no relief (1 case) of pain symptoms in patients suffering from reflex sympathetic dystrophy (54). Nimodipine given orally at a dose of 30 mg every 8 h for 3 days did not change the analgesia produced by the concomitant use of morphine in the earlier phase of treatment for cancer pain (55).…”

Section: Clinical Studiesmentioning

confidence: 97%

Involvement of calcium in pain and antinociception

2001

Braz J Med Biol Res

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Calcium ions are widely recognized to play a fundamental role in the regulation of several biological processes. Transient changes in cytoplasmic calcium ion concentration represent a key step for neurotransmitter release and the modulation of cell membrane excitability. Evidence has accumulated for the involvement of calcium ions also in nociception and antinociception, including the analgesic effects produced by opioids. The combination of opioids with drugs able to interfere with calcium ion functions in neurons has been pointed out as a useful alternative for safer clinical pain management. Alternatively, drugs that reduce the flux of calcium ions into neurons have been indicated as analgesic alternatives to opioids. This article reviews the manners by which calcium ions penetrate cell membranes and the changes in these mechanisms caused by opioids and calcium antagonists regarding nociceptive and antinociceptive events.

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Section: Clinical Studiesmentioning

confidence: 97%

Involvement of calcium in pain and antinociception

2001

Braz J Med Biol Res

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“…Calcium-channel blockade with nifedipine has been reported to be effective in managing the vasoconstriction occurring in this phase of CRPS [76, 79]. Additionally, the use of gamma-aminobutyric acid-β (GABA) agonist such as baclofen has also been effective in reducing dystonia and pain while improving functionality and quality of life in patients with chronic CRPS [80–82].…”

Section: Reviewmentioning

confidence: 99%

Complex regional pain syndrome: a recent update

2017

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Complex regional pain syndrome (CRPS) is a debilitating condition affecting the limbs that can be induced by surgery or trauma. This condition can complicate recovery and impair one’s functional and psychological well-being. The wide variety of terminology loosely used to describe CRPS in the past has led to misdiagnosis of this condition, resulting in poor evidence-base regarding the treatment modalities available and their impact. The aim of this review is to report on the recent progress in the understanding of the epidemiology, pathophysiology and treatment of CRPS and to discuss novel approaches in treating this condition.

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“…Two studies of moderate quality and size investigated the effect of nifedipine and phenoxybenzamine in treating CRPS-I [44,45]. One retrospective study with 59 patients reports that nifedipine (20 mg per day) or phenoxybenzamine (up to 120 mg/day) are most effective for CRPS-I in the acute phase [44].…”

Section: Resultsmentioning

confidence: 99%

Evidence based guidelines for complex regional pain syndrome type 1

et al. 2010

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BackgroundTreatment of complex regional pain syndrome type I (CRPS-I) is subject to discussion. The purpose of this study was to develop multidisciplinary guidelines for treatment of CRPS-I.MethodA multidisciplinary task force graded literature evaluating treatment effects for CRPS-I according to their strength of evidence, published between 1980 to June 2005. Treatment recommendations based on the literature findings were formulated and formally approved by all Dutch professional associations involved in CRPS-I treatment.ResultsFor pain treatment, the WHO analgesic ladder is advised with the exception of strong opioids. For neuropathic pain, anticonvulsants and tricyclic antidepressants may be considered. For inflammatory symptoms, free-radical scavengers (dimethylsulphoxide or acetylcysteine) are advised. To promote peripheral blood flow, vasodilatory medication may be considered. Percutaneous sympathetic blockades may be used to increase blood flow in case vasodilatory medication has insufficient effect. To decrease functional limitations, standardised physiotherapy and occupational therapy are advised. To prevent the occurrence of CRPS-I after wrist fractures, vitamin C is recommended. Adequate perioperative analgesia, limitation of operating time, limited use of tourniquet, and use of regional anaesthetic techniques are recommended for secondary prevention of CRPS-I.ConclusionsBased on the literature identified and the extent of evidence found for therapeutic interventions for CRPS-I, we conclude that further research is needed into each of the therapeutic modalities discussed in the guidelines.

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Efficacy of Oral Nifedipine in the Treatment of Reflex Sympathetic Dystrophy

Cited by 83 publications

References 0 publications

Involvement of calcium in pain and antinociception

Involvement of calcium in pain and antinociception

Complex regional pain syndrome: a recent update

Evidence based guidelines for complex regional pain syndrome type 1

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