Vasodilative effect of isosorbide dinitrate ointment in complex regional pain syndrome type 1

The Clinical Journal of Pain
George GroenewegFreek J Zijlstra

Abstract

In complex regional pain syndrome type 1 (CRPS1) vascular changes occur from the initial, inflammatory event onto the trophic signs during chronicity of the disease, resulting in blood flow disturbances and marked temperature changes. Pharmacotherapeutic treatment is generally inadequate. To determine whether local application of the nitric oxide donor isosorbide dinitrate (ISDN) could cause vasodilation and thereby improve tissue blood distribution in the affected extremity. In a pilot study, 5 female patients with CRPS1 in one hand were treated with ISDN ointment 4 times daily during 10 weeks. As a primary objective videothermography was used to monitor changes in blood distribution in both the involved and contralateral extremities. Patients treated with ISDN showed an increase of 4 degrees C to 6 degrees C in mean skin temperature of the cold CRPS1 hands, reaching values similar to that of the contralateral extremities within 2 to 4 weeks time, suggesting normalization of blood distribution. This was confirmed by an improvement in skin color. In 3 patients the Visual Analog Scale pain declined, whereas in the other 2 patients the Visual Analog Scale pain was unchanged over time. In this pilot study, topical application of I...Continue Reading

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Citations

Apr 2, 2010·BMC Neurology·Roberto S PerezUNKNOWN CRPS I task force
Jun 13, 2013·Journal of Materials Science. Materials in Medicine·Rafael VercelinoMarcelo G de Oliveira
Aug 14, 2010·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Terence J Coderre, Gary J Bennett
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Jun 12, 2009·Journal of Pain and Symptom Management·J George GroenewegFreek J Zijlstra
Nov 9, 2015·Pain Practice : the Official Journal of World Institute of Pain·Minke C KortekaasFrank J P M Huygen
Apr 17, 2015·BMC Health Services Research·Robyn AdamsLorraine Sheppard
Mar 22, 2014·Anesthesia and Analgesia·André LaferrièreTerence J Coderre

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