| Intra-arterial Administration of Reserpine and Proeaine with Stellate Ganglion Rloek for Raynauds Phenomenon . |
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Jae Kyu Jeon, Jung Gil Jung, Kyu Taek Choi, Sun Ok Song |
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Department of Anesthesiology, Keimyung University School of Medicine, Taegu, Korea. |
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| Abstract |
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Efforts from many different approaches have been made to cure Raynand's phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentral administration of various drugs. However, there has been no successful management proven yet. In recent years, it was reported that intra-arterial administration in normal subjects as well as patients with Raynaud's syndrome has demonstrated a significant rise in blood flow to the hands. We used intermittent stellate ganglion blocks in conjunction with intra-arterial injections of reserpine and procaine in 10 patients suffering from finger necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 1% lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1mg and procaine 50mg through a butterfly needle inserted in the radial or brachial artery. The administration of reserpine and procaine was done only twice at intervals of 1 week because of the development of suspected arterisclerosis. The stellate ganglion block was carried out once a week for about 3 months, then once a month as needed for 6 to 12 months. AS the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were healed completely and the rest improved considerably but were not followed to the end.
We concluded that the intra-arterial administration of reserpine and procaine helped initiate and accelerate increasing blood flow to the hand and the stellate ganglion block continued to help revascularization by dilating the peripheral beds. |
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