[Modification of the guanethidine block for diagnosing reflex sympathetic dystrophy.].

Der Schmerz
U Hoffmann, H Blumberg

Abstract

For diagnosis of the pain origin in reflex sympathetic dystrophy (RSD), sympathetic blocks, including the intravenous regional guanethidine (IVRG) block after Hannington-Kiff, are recommended. Since the results obtained with this kind of block are sometimes unsatisfactory, modifications were made to increase its technical efficacy. Forty-seven RSD patients were investigated. Among the typical triad of RSD symptoms, all patients showed distally generalized oedema of the affected extremity and complained of spontaneous pain. This pain showed an orthostatic component in all but two patients. The modifications of the IVRG-block were: (1) distal (in contrast to proximal) suprasystolic compression of the affected extremity before i.v. injection of guanethidine (GA); (2) reduction of the recommended dose of GA (10-30 mg) to 2.5 mg GA for each block; (3) no additional local anaesthetics, which are recommended for suppression of the typical pain following GA injection, since this pain allows identification of the distribution of the GA (complete? incomplete?) within the symptomatic area; (4) repeated subsequent injection of physiological saline to improve the distribution of GA within the symptomatic area. Injection of GA and repeated i...Continue Reading

Citations

Apr 16, 1999·Pain·N SiewekeH O Handwerker
Jul 27, 2004·Personality & Social Psychology Bulletin·Ilja van BeestEric van Dijk
Jan 11, 2019·PloS One·Robert J DiNapoliMatthew Becker
Oct 20, 2020·Pain Practice : the Official Journal of World Institute of Pain·Johann LambeckMatthias Reinhard

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