Treatment of early complex regional pain syndrome type 1 by a combination of mannitol and dexamethasone.
A total of 75 patients, 68 women (91%) and seven men (9%), with a mean age of 58 (range 38-82) years with early Complex Regional Pain Syndrome Type 1 (CRPS Type 1), present for less than 4 months, were given in-patient treatment with 10% mannitol 2 x 250 ml per day and 8 mg dexamethasone per day for 1 week. Measurements assessed included the pain, the range of finger movements, grip strength and our own clinical severity scoring system for CRPS Type 1 (CRPS score). The results were assessed at 1 week and, finally, at a mean of 9 (range 8-12) months. At 1-week assessment, all variables decreased significantly: pain from a mean Visual Analogue Scale (VAS) of 6.7 to 2.3, loss of finger flexion (6-0.3 cm) and the CRPS score (7.6-2.2 points). Total grip strength did not improve. At the final assessment of 70 patients, the VAS score was a mean of 1.8, loss of finger flexion a mean of 0.1 cm, the CRPS score was a mean of 1.6 and grip strength a mean of 34% of the strength of the unaffected hand. All these variables showed statistically significant improvement.
Zyluk
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A
Department of General and Hand Surgery, Pomeranian Medical University, Szczecin, Poland. azyluk@hotmail.com
Puchalski
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P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D018737:Hand Strength; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008353:Mannitol / Q000008:administration & dosage*; D008875:Middle Aged; D010147:Pain Measurement; D012019:Reflex Sympathetic Dystrophy / Q000188:drug therapy*
D008353:Mannitol; D003907:Dexamethasone