Thoracoscopic sympathectomy is a valuable addition in the management of recreational intra-arterial drug injection. Pilot study

International Journal of Surgery
Ayman El SamadoniHisham Mostafa

Abstract

Intra-arterial Injection (IAI) of illicit substances by drug abusers may result in acute ischemia, limb loss or permanent functional deficit. No prospective human studies have shown that any specific treatment is superior to another. Thoracoscopic sympathectomy (TS) has proven efficacy in upper limb ischemia due to organic blockade. This is a pilot study to evaluate the effect of thoracoscopic sympathectomy addition to the management protocol of recreational intra-arterial drug injection. A total of 11 victims of upper limb IAI of recreational drug were recruited (10 males) with age range from 18 to 43 years old (average 30+/-8.3 years). Tissue Ischemia Score (TIS) was used for pretreatment assessment of the degree of ischemic injury and severity of pain was evaluated pre- and post-operatively using visual analog score (VAS) and compared using Student's t test. Pre-operative VAS score was 6.9+/-1.8. All enrolled patients were treated according to the following protocol; anticoagulation, calcium channel blocker, opiates for pain, and TS. Patients received the stated protocol for minimum of 72h (range 3-8 days; mean 5; average 4.7+/-1.5 days). Freedom of amputation and improvement of pain scores were the study endpoints. No morta...Continue Reading

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Citations

Jun 10, 2011·Journal of Vascular Surgery·Hans M E CoveliersJan A Rauwerda
Oct 4, 2019·The Cochrane Database of Systematic Reviews·Li YeChunjie Li
Aug 4, 2018·Hand : Official Journal of the American Association for Hand Surgery·Anastassia NewburyJoseph J Thoder

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