title: [Severe ischemia of the hand. Treatment with regional intravenous sympathicolysis with reserpine].
abstract: Treatment of severe hand ischemia a associated to progressive systemic sclerosis and other disorders is controversial. We studied prospectively 45 patients, 41 female and 4 males, over an 11 year period. Age ranged from 16 to 73 years, mean 46. Underlying disease was systemic sclerosis in 30, CREST in 8, overlapping syndrome in 4, systemic lupus in 1 and non rheumatic vasculitis in 2 patients. Treatment consisted of intravenous injection of reserpine, 1 mg, at a superficial arm vein after controlled local circulatory block for 15 min. Regional anesthesia was required in 38 patients. Adequate follow up was obtained in 32 females and 2 males, receiving a mean of 3.1 therapy sessions (range 1 to 13). Morphologic improvement from 3.09 +/- 0.16 to 1.57 +/- 0.13 and functional improvement from 3.6 +/- 0.12 to 1.75 +/- 0.14 (5 grade scoring system), was observed (p < 0.001). These results correlate with adequate rehabilitation confirmed clinically.
authors.affiliation: Servicio de Cirugía, Hospital del Salvador, Santiago de Chile.
authors.forename: A
authors.initials: A
authors.lastname: Acevedo
authors.forename: S
authors.initials: S
authors.lastname: Palma
authors.forename: L
authors.initials: L
authors.lastname: Guzmán
authors.forename: M
authors.initials: M
authors.lastname: Grisanti
authors.forename: J
authors.initials: J
authors.lastname: Basualdo
authors.forename: C
authors.initials: C
authors.lastname: Cerda
authors.forename: L
authors.initials: L
authors.lastname: Toledo
authors.forename: J
authors.initials: J
authors.lastname: Díaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007275:Injections, Intravenous; D007511:Ischemia / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011928:Raynaud Disease / Q000150:complications; D012110:Reserpine / Q000008:administration & dosage*; D012720:Severity of Illness Index
chemical_list: D012110:Reserpine
vernacular_title: Isquemia severa de la mano. Tratamiento con simpaticolisis regional intravenosa con reserpina.