Regional intravenous guanethidine blocks in algodystrophy

Eulry, F; Lechevalier, D.; Pats, B.; Alliaume, C.; Crozes, P.; Vasseur, P; Coutant, G.; Felten, D; Pattin, S

doi:10.1007/bf02206656

Cited by 23 publications

(7 citation statements)

References 11 publications

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“…[27] In addition, smoking is considered to be related to the proximal airway obstruction in AS. [28] Moreover, smoking leads to higher BASDAI and BASFI scores and significantly lower forced vital capacity in AS. [29] Smokers have often worse functional and physical condition compared to non-smokers.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of comorbidity and predictors in ankylosing spondylitis

Gökşenoğlu¹,

Buğdaycı²,

Paker³

et al. 2019

Turk J Phys Med Rehab

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Objectives: The aim of the present study was to investigate the prevalence of comorbidities and related factors in patients with ankylosing spondylitis (AS). Patients and methods: Between June 2013 and January 2014, a total of 100 patients with AS (64 males, 36 females; mean age 43.1±10.7 years; range, 25 to 73 years) who were under routine follow-up in the outpatient clinic were included in this cross-sectional study. The demographic characteristics of the patients were recorded. The Ankylosing Spondylitis Disease Activity Scale (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) scores were calculated. Comorbidities were evaluated using the modified Cumulative Illness Rating Scale (CIRS). Both the number and severity of the affected systems were scored. Results: The mean amount of cigarette consumption was 17.3±13.5 pack/year. The mean disease duration was 191.3±122.4 months. The BASFI, BASDAI, BASMI, and ASDAS-C-reactive protein scores were 3.4±2.3, 3.7±2.0, 4.5±1.8, and 2.5±0.9, respectively. The mean number of system-related problems was 4.3 (range, 1 to 11). The mean CIRS scores for the severity of comorbidities were 7.36±3.48 (range, 3 to 23). The most frequent system combinations were hematopoietic, eye, ear, nose and throat, and upper gastrointestinal in 11 patients, hematopoietic, respiratory and upper gastrointestinal in 11 patients, and hematopoietic, respiratory and eye, ear, nose and throat in 10 patients. When the estimated total CIRS scores was assessed in the multivariate reduced model, age, disease duration, and BASFI values showed a significant independent effect. Conclusion: Our study results showed that the frequency of comorbidities was more than four, although the severity of system problems were mild in AS patients as measured by CIRS. The most frequently involved systems included hematopoietic, upper gastrointestinal, lower gastrointestinal, renal, and musculoskeletal-skin systems. Age, disease duration, and BASFI scores were found to be predictors of comorbidities in our patients.

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Section: Discussionmentioning

confidence: 99%

The prevalence of comorbidity and predictors in ankylosing spondylitis

Gökşenoğlu¹,

Buğdaycı²,

Paker³

et al. 2019

Turk J Phys Med Rehab

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“…Most authors agree that early identification and treatment of CRPS type 1 improve the outcome, regardless of the method of treatment. 6,8,9,[33][34][35] Studies of the natural history of CRPS type 1 suggest that spontaneous resolution is the usual outcome and failure to account for this in uncontrolled studies may exaggerate the efficacy of treatment. 18,19 This tendency to resolution may explain the apparent therapeutic response in patients with mild disease in both control and treatment groups.…”

Section: Discussionmentioning

confidence: 99%

Intravenous regional guanethidine blockade in the treatment of post-traumatic complex regional pain syndrome type 1 (algodystrophy) of the hand

Livingstone

Atkins

2002

The Journal of Bone and Joint Surgery

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A total of 57 patients, aged between 23 and 86 years, with complex regional pain syndrome (CRPS) type 1 nine weeks after an isolated closed fracture of the distal radius, was randomised to receive either serial intravenous regional blockade (IVRB) with 15 mg of guanethidine in 30 ml of 0.5% prilocaine or serial IVRB with 30 ml of normal saline at weekly intervals until the tenderness in their fingers had resolved or they had received a maximum of four IVRBs. The analgesic efficacy was assessed at 24 hours, 48 hours and one week after each procedure by the dolorimetry ratio and verbal pain scores, and at intervals up to six months after the fracture. There was no significant difference in the number of IVRBs administered or in finger tenderness, stiffness or grip strength between the two groups. The guanethidine group experienced more pain in the affected hand (p = 0.025) and at six months had more vasomotor instability (p < 0.0001) compared with the control group. IVRB using guanethidine offers no significant analgesic advantage over a normal saline placebo block in the treatment of early CRPS type 1 of the hand after fracture of the distal radius. It does not improve the outcome of this condition and may delay the resolution of vasomotor instability when compared with the placebo.

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“…In a review of the literature only one other case report using calcium in a similar intravenous regional technique was found 20 , although in other conditions many other drugs have been given by intravenous regional administration. These include steroids 21 , opioids 22 , vasodilators 23 , antibiotics 24 and antiinflammatory drugs 25 .…”

Section: Discussionmentioning

confidence: 99%

Intravenous regional calcium gluconate for hydrofluoric acid burns of the digits

Wilkes

1993

Emergency Medicine

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Objective: To describe an alternative, simple and effective treatment of digital burns from hydrofluoric acid. Clinical features: Two patients are described with typical presentations from digital exposure to hydrofluoric acid. In both cases topical treatment with calcium gluconate gel was unsuccessful in relieving symptoms. Intervention and outcome: Both patients were successfully treated with intravenous regional calcium gluconate based on a Bier's block technique. Conclusion: Digital burns from hydrofluoric acid resistant to treatment with calcium gluconate gel may be successfully treated with this technique, without the need for removal of finger nails or the complicated, protracted technique of intra‐arterial calcium infusions.

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Regional intravenous guanethidine blocks in algodystrophy

Cited by 23 publications

References 11 publications

The prevalence of comorbidity and predictors in ankylosing spondylitis

The prevalence of comorbidity and predictors in ankylosing spondylitis

Intravenous regional guanethidine blockade in the treatment of post-traumatic complex regional pain syndrome type 1 (algodystrophy) of the hand

Intravenous regional calcium gluconate for hydrofluoric acid burns of the digits

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