Year: 2008
Type: dissertation
Abstract: Clinical practice guideline ‘Complex regional pain syndrome type I’ The development and treatment of the complex regional pain syndrome type I (CRPS-I) are a subject of much discussion. Using the method for the development of evidence-based guidelines, a multidisciplinary guideline for the diagnosis and treatment of this syndrome has been drawn up. The diagnosis of CRPS-I is based on the clinical observation of signs and symptoms. For pain treatment, the WHO analgesic ladder is advised up to step 2. In case of pain of a neuropathic nature, anticonvulsants and tricyclic antidepressants may be considered. For the treatment of inflammatory symptoms, free-radical scavengers (dimethylsulphoxide or acetylcysteine) are advised. In order to enhance peripheral blood flow, vasodilatory medication may be considered. Percutaneous sympathetic blockades may be used for a cold extremity if vasodilatory medication produces insufficient effect. To decrease functional limitations, standardised physiotherapy and occupational therapy are advised. To prevent the occurrence of CRPS-I after wrist fractures, the use of vitamin C is recommended. Adequate perioperative analgesia, limitation of operation time and limited use of tourniquet are advised for the secondary prevention of CRPS-I. Use of regional anaesthetic techniques can also be considered in this connection. Reprinted with permission from Nederlands Tijdschrift voor Geneeskunde, 151, R.S.G.M. Perez, P.E. Zollinger, P.U. Dijkstra, I.L Thomassen-Hilgersom, W.W.A. Zuurmond, C.J.G.M. Rosenbrand, J.H.B. Geertzen: Richtlijn ‘Complex regionaal pijn syndroom type I’, 1674-79, Copyright 2007. •
Author: Paul E. Zollinger
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1600563062