Abstract：
:The microcirculation appears to be impaired in cold chronic complex regional pain syndrome (CRPS). This double-blind, placebo-controlled, randomized trial investigated the effect of the nitric oxide (NO) donor isosorbide dinitrate (ISDN) on the peripheral blood flow in patients with chronic CRPS. Twenty-four patients received 1% ISDN in Vaseline or a placebo ointment applied to the dorsum of the affected hand four times daily for 10 weeks. The patients participated in a physical therapy program to improve activity. The primary outcome measure was blood distribution in the affected extremity, which was determined by measuring the skin temperature using videothermography. We also measured NO and endothelin-1 concentrations in blister fluid, pain using the visual analog scale, and activity limitations using an upper limb activity monitor and the Disabilities of Arm Shoulder and Hand Questionnaire. ISDN failed to produce a significant improvement in temperature asymmetry in chronic cold CRPS patients, and it did not result in the expected reduction in pain and increase in activity compared with placebo either. There may be other central or peripheral factors contributing to the disturbed vasodynamics in cold chronic CRPS that are not influenced by NO substitution. This study does not show an improvement of the regional blood distribution by ISDN in the involved extremity of patients with cold-type CRPS.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Groeneweg JG,Huygen FJ,Niehof SP,Wesseldijk F,Bussmann JB,Schasfoort FC,Stronks DL,Zijlstra FJdoi
10.1016/j.jpainsymman.2008.10.006subject
Has Abstractpub_date
2009-09-01 00:00:00pages
401-8issue
3eissn
0885-3924issn
1873-6513pii
S0885-3924(09)00452-7journal_volume
38pub_type
杂志文章,随机对照试验abstract：CONTEXT:Advanced, life-limiting illnesses are likely to have a predictable functional decline through a terminal phase to death, but some patients may also die suddenly. To date, empirical evidence characterizing "sudden death" in hospice/palliative care is lacking. OBJECTIVES:The aim of this study was to determine pr...
journal_title：Journal of pain and symptom management
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