title: Sympathetic blockade and amitriptyline in the treatment of reflex sympathetic dystrophy.
abstract: We prospectively investigated the outcome of a combination therapy of oral amitriptyline and sympathetic ganglion blockade on 10 patients suffering from reflex sympathetic dystrophy of the upper extremity for at least three months. The efficacy of the treatment was evaluated by clinical examination, pain ratings on the visual analogue scale (VAS) and grip strength measurements using the Jamar dynamometer. The results were statistically analysed with Wilcoxon signed-ranks test for comparison of the before and after treatment grip strength measurements and with paired t-test for comparison of the mean of initial and consecutive pain ratings on the VAS. Values of p < 0.01 were considered to be statistically significant. Combination therapy proved beneficial in this particular patient population, which, as far as previously documented studies are concerned, would otherwise respond less favourably to a treatment consisting solely of sympathetic blockade.
authors.affiliation: Departments of Orthopaedics, University of Gaziantep, Gaziantep, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Karakurum
authors.forename: L
authors.initials: L
authors.lastname: Pirbudak
authors.forename: U
authors.initials: U
authors.lastname: Oner
authors.forename: A
authors.initials: A
authors.lastname: Gulec
authors.forename: H
authors.initials: H
authors.lastname: Karadasli
authors.forename: T
authors.initials: T
authors.lastname: Satana
mesh_terms: D000328:Adult; D000639:Amitriptyline / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012019:Reflex Sympathetic Dystrophy / Q000188:drug therapy*; D013565:Sympatholytics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D013565:Sympatholytics; D000639:Amitriptyline; D002045:Bupivacaine