The Incidence of Complex Regional Pain Syndrome After Fasciectomy for Dupuytren’s Contracture: A Prospective Observational Study of Four Anesthetic Techniques: Retracted
| Autor: | Steven Wenner, Scott S. Reuben, Duane Dixon, Rene Pristas, Shameema Faruqi, Lakshmi Madabhushi |
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| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Lidocaine business.industry medicine.medical_treatment Perioperative medicine.disease Surgery Fasciotomy Clonidine Anesthesiology and Pain Medicine Complex regional pain syndrome Anesthesia medicine Nerve block Contracture medicine.symptom Dupuytren's contracture business medicine.drug |
| Zdroj: | Anesthesia & Analgesia. 102:499-503 |
| ISSN: | 0003-2999 |
| Popis: | The development of complex regional pain syndrome (CRPS) is not an uncommon complication after Dupuytren's surgery. Despite increasing research interest, little is known regarding which patients are at increased risk for developing CRPS and what is the optimal perioperative treatment strategy for preventing the occurrence of this disease after surgery. We prospectively evaluated the use of four anesthetic techniques (general anesthesia, axillary block, and IV regional anesthesia [IVRA] with lidocaine with or without clonidine) for patients undergoing fasciectomy for Dupuytren's contracture. All patients were followed in the Pain Management Center at 1, 3, and 12 mo postoperatively by a blinded physician to evaluate the presence of CRPS. Significantly (P < 0.01) more patients developed postoperative CRPS in the general anesthesia group (n = 25; 24%) and the IVRA lidocaine group (n = 12; 25%) compared with either the axillary block group (n = 5; 5%) or the IVRA lidocaine and clonidine group (n = 3; 6%). We conclude that axillary block or IVRA with clonidine offers a significant advantage for decreasing the incidence of CRPS compared with either IVRA with lidocaine alone or general anesthesia for patients undergoing Dupuytren's surgery. |
| Databáze: | OpenAIRE |
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