Abstract | BACKGROUND AND OBJECTIVES: METHODS: A prospective, randomized, double-blinded, crossover design was used. The primary outcome was overall pain numeric rating scale (NRS) at 1 week postinjection; secondary outcomes included pain with motion, allodynia, joint pain score, edema, range of ankle motion, skin temperature, and short-term pain relief. Ten of 12 adult patients diagnosed with unilateral lower extremity CRPS (type I) completed the study. Four IVRBs were performed 1 week apart in a random sequence with 50 mL lidocaine 0.5% and 0, 30, 60, and 120 mg ketorolac. RESULTS: Only 1 outcome achieved significant improvement; there was 1 day of significant pain reduction in the ketorolac groups (median NRS 6 to 4, P=0.002). Overall pain NRS (10-point scale, mean±SE) at 1 week was 6.2±0.53, 6.5±0.89, 6.0±0.88, 5.9±0.82, and 5.8±0.9 at baseline, 0, 30, 60, and 120 mg, respectively (P=0.8). Pain with movement was 7.15±0.69, 5.7±1.07, 6.1±0.86, 5.0±0.97, and 5.6±0.86, (P=0.059). Edema was not significantly reduced (2% reduction, P=0.6). CONCLUSIONS: IVRB with ketorolac and lidocaine produced only short-term pain reduction in patients with CRPS involving the lower extremity after 4 serial injections in our study group. Prospective study is warranted, particularly in the pediatric population.
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Authors | Maxim Savillion Eckmann, Somayaji Ramamurthy, James G Griffin |
Journal | The Clinical journal of pain
(Clin J Pain)
2011 Mar-Apr
Vol. 27
Issue 3
Pg. 203-6
ISSN: 1536-5409 [Electronic] United States |
PMID | 21358290
(Publication Type: Journal Article, Randomized Controlled Trial)
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Chemical References |
- Anesthetics, Local
- Drug Combinations
- Lidocaine
- Ketorolac
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Topics |
- Adult
- Anesthetics, Local
(administration & dosage)
- Complex Regional Pain Syndromes
(diagnosis, drug therapy)
- Cross-Over Studies
- Double-Blind Method
- Drug Combinations
- Female
- Humans
- Injections, Intravenous
- Ketorolac
(administration & dosage)
- Lidocaine
(administration & dosage)
- Male
- Middle Aged
- Nerve Block
(methods)
- Pain Measurement
(drug effects)
- Treatment Outcome
- Young Adult
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