Jan 24, 2014

Phenoxybenzamine in complex regional pain syndrome: potential role and novel mechanisms

Anesthesiology Research and Practice
Mario A Inchiosa

Abstract

There is a relatively long history of the use of the α -adrenergic antagonist, phenoxybenzamine, for the treatment of complex regional pain syndrome (CRPS). One form of this syndrome, CRPS I, was originally termed reflex sympathetic dystrophy (RSD) because of an apparent dysregulation of the sympathetic nervous system in the region of an extremity that had been subjected to an injury or surgical procedure. The syndrome develops in the absence of any apparent continuation of the inciting trauma. Hallmarks of the condition are allodynia (pain perceived from a nonpainful stimulus) and hyperalgesia (exaggerated pain response to a painful stimulus). In addition to severe, unremitting burning pain, the affected limb is typically warm and edematous in the early weeks after trauma but then progresses to a primarily cold, dry limb in later weeks and months. The later stages are frequently characterized by changes to skin texture and nail deformities, hypertrichosis, muscle atrophy, and bone demineralization. Earlier treatments of CRPS syndromes were primarily focused on blocking sympathetic outflow to an affected extremity. The use of an α -adrenergic antagonist such as phenoxybenzamine followed from this perspective. However, the curre...Continue Reading

  • References37
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Mentioned in this Paper

Trichohepatoenteric Syndrome
Reflex Sympathetic Dystrophy
Decreased Sympathetic Activity [PE]
Sympathetic Nervous System
Anti-Inflammatory Agents
Hypertrichosis
Etiology
Gene Expression
Limb Structure
Muscular Atrophy

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