Mannitol as salvage treatment for Complex Regional Pain Syndrome Type i

8Citations
Citations of this article
24Readers
Mendeley users who have this article in their library.

Abstract

Introduction: Complex Regional Pain Syndrome Type I (CRPS I) is a continuation of symptoms and signs due to a pathological exaggerated reaction in an extremity of the human body after an injury or operation. Although the clinical picture of CRPS I in the majority of patients is well known, the underlying pathophysiology remains unclear. In the Netherlands, intravenous mannitol administration used as hydroxyl radical scavenger for patients who do not respond to conservative treatment of CRPS I is advocated but little evidence supports this salvage strategy. In this study the effect of mannitol as salvage medication was evaluated in a well-defined multimodal step-up treatment protocol. Patients and methods: A consecutive group of 68 adult patients with persistent CRPS I was analysed, who underwent a total of 100 mannitol infusions. The effect of treatment was considered per sign and per symptom according to the Veldman et al. criteria for CRPS I. Results: Overall improvement of CRPS I after mannitol treatment was successful in 24% after 1 week, and in 30% after 1 month. Mannitol treatment had some effect in patients with initially warm CRPS I in contrast to patients with cold CRPS I (OR = 6.30 with CI [2.37-16.75]). Also patients with CRPS I at the upper extremity had more benefit than patients with CRPS I at the lower extremity (OR = 3.26 with CI [1.34-7.93]). Poor results of mannitol treatment were associated with cold CRPS I (p < 0.001), chronic CRPS I (p = 0.04) and multiple mannitol treatments (p = 0.04). Conclusion: Mannitol did not significantly contribute to the overall success of treatment in patients with CRPS I. Patients, presenting with acute, warm CRPS I in the upper extremity may have some benefit. © 2009 Elsevier Ltd. All rights reserved.

Cite

CITATION STYLE

APA

Tan, E. C. T. H., Tacken, M. C. T., Groenewoud, J. M. M., Van Goor, H., & Frölke, J. P. M. (2010). Mannitol as salvage treatment for Complex Regional Pain Syndrome Type i. Injury, 41(9), 955–959. https://doi.org/10.1016/j.injury.2009.11.013

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free