- Title
- A novel compound analgesic cream (Ketamine, Pentoxifylline, Clonidine, DMSO) for complex regional pain syndrome patients
- Creator
- Russo, Marc A.; Santarelli, Danielle M.
- Relation
- Pain Practice Vol. 16, Issue 1, p. E14-E20
- Publisher Link
- http://dx.doi.org/10.1111/papr.12404
- Publisher
- Wiley-Blackwell Publishing
- Resource Type
- journal article
- Date
- 2016
- Description
- Background: Evidence suggests that complex regional pain syndrome (CRPS) is a manifestation of microvascular dysfunction. Topical combinations of α2-adrenergic receptor agonists or nitric oxide donors with phosphodiesterase or phosphatidic acid inhibitors formulated to treat microvascular dysfunction have been shown to reduce allodynia in a rat model of CRPS-I. Driven by these findings, we assessed the outcomes of CRPS patients treated with a compound analgesic cream (CAC) consisting of ketamine 10%, pentoxifylline 6%, clonidine 0.2%, and dimethyl sulfoxide 6% to 10%. Methods: An audit was conducted on 13 CRPS patients who trialed the CAC. A detailed report was compiled for each patient which comprised baseline characteristics, including CRPS description, previous treatments, and pain scores (numerical pain rating scale; 0 to 10). Recorded outcomes consisted of pain scores, descriptive outcomes, and concurrent medications/treatments, for which basic analysis was performed to determine the effectiveness of the CAC. Case reports are presented for 3 patients with varying outcomes. Results: Nine patients (69%) reported pain/symptom reduction (4.4 ± 2.1 vs. 6.3 ± 1.9) with use of the CAC. Six patients reported sustained benefits after 2 months of CAC use, and 2 patients reported complete resolution of pain/symptoms: one had early CRPS-I and the other received a partial CRPS diagnosis. An otherwise medication refractory and intolerant patient found partial benefit with the CAC. Conclusions: These results demonstrate promise for this topical combination as a useful treatment in multimodal therapy for patients with CRPS, with the potential to resolve pain/symptoms in early CRPS patients.
- Subject
- complex regional pain syndrome; pentoxifylline; clonidine; ketamine; NO donor; dimethyl sulfoxide; nitric oxide complex regional pain syndrome
- Identifier
- http://hdl.handle.net/1959.13/1347660
- Identifier
- uon:30093
- Identifier
- ISSN:1530-7085
- Language
- eng
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