title: Treatment of complex regional pain syndrome type I of the hand with a series of intravenous regional sympathetic blocks with guanethidine and lidocaine.
abstract: The aim of this study was to evaluate the efficacy of guanethidine and lidocaine in the treatment of complex regional pain syndrome (CRPS) type I of the hand. Seventeen patients, aged between 33 and 72 years, suffering from CRPS type I of the hand received two series of intravenous regional sympathetic block (Bier's block) sessions with guanethidine and lidocaine according to the following therapeutic protocol: (1) 5 sessions (once every second day) composed of intravenous regional administration of 15 mg guanethidine and 1 mg lidocaine/kg body weight each and (2) 20 sessions (twice a week) composed of intravenous regional administration of 10 mg guanethidine and 1 mg lidocaine/kg body weight each. Complete disappearance of pain and return of the normal function and movement of the extremity were achieved. No side effects were observed. The above-described therapeutic protocol method resulted in excellent pain relief and full restoration of both function and range of movement of the affected extremity in 17 patients suffering from CRPS type I of the hand.
authors.affiliation: Department of Vascular Surgery, Athens University Medical School, Athens, Greece.
authors.forename: Kosmas I
authors.initials: KI
authors.lastname: Paraskevas
authors.forename: Alexandra A
authors.initials: AA
authors.lastname: Michaloglou
authors.forename: Despina D
authors.initials: DD
authors.lastname: Briana
authors.forename: Maria
authors.initials: M
authors.lastname: Samara
mesh_terms: D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use*; D001340:Autonomic Nerve Block / Q000379:methods*; D020918:Complex Regional Pain Syndromes / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D005260:Female; D006145:Guanethidine / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D020127:Recovery of Function / Q000187:drug effects; D013565:Sympatholytics / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D013565:Sympatholytics; D008012:Lidocaine; D006145:Guanethidine