Barbiturate-induced algodystrophy

S283

CHRONICPERIPHERALPAIN AND HEMODYNAMICS.

, Y.Suzuki * , R.

, H.Komiyama * , Y.Aoyama *

K.Nagata *

Murayama, (SPON: M.Yamamoto), Department of Anesthesiology, University,

Oohashi Hospital,

Aims of Investigation:

Toho

Tokyo, 153, Japan

The patients

complaining chronic peripheral

pain of glove and

stocking type are so many. This type of pain has been considered to be psychological. treatment

is very difficult

these patients

even with psychotherapy.

with tilting tests,

The

We examined the hemodynamics of

because their symotoms tend to get worse in standing

position. Methods: Subjects were 14 cases with peripheral pain (glove and stocking type), complaining pain,

numbness,

and frigidity

of extremities,

and 22 cases as normal controles.

Hemodynamics with Shellong’s tilting tests were measured non-invasively and BoMed NCCOM(non-invasive Results: In patients

continuous cardiac output monitor).

with peripheral

pain,

hypotension,

volume, and high systemic vascular resistance normal controle.

pain patients,

hemodynamical problems exists. Moreover,

low cardiac output,

were recognized statistically

These findings were intensified

Conclusions: In peripheral

by Parama GP303s low stroke

compared with

by tilting tests.

not only psychological

problems but

lowcardiac output causes high peripheral

resistance,

then the vicious circle is completed in chronic course. The base of the

disturbance

is considered to be in autonomic nervous systems especially

in the cardiac

inotropic action. BARBITURATE-INDUCED Santis^ ,F.Crotti^:G.de

ALGODYSTROPHY.R.Massei’,A.de Benedittis’)M.Baiguini^:M.

/ ~~~;5”5’” / Tagliabue'and R.Pozzi!Departements of Anesthesiology,-Neurosurgery and "Pain Research and Treatment Unit,Univer sity of Milan,Italy. Aim of 1nvestigation:Algodystrophy is due to an association of factors. Numerous favoring circumstances, as traumatism,non traumatic affections of the locomotor apparatus and cardiovascu lar diseases,play an important role in this syndrome. In the literature, iatrogenic algodystrophies have been described,anong which,barbiturate-induced ones.Our study shows the frequency of this oonditijanin patients treated with barbiturate for non epilepticpathology of the CNS. Methods:Among our 12 patients (6 F., 6 M.),all older than 30 years,ten underwent surgery(5 cerebral aneurism,3 meningiomas 1 cerebral traumatic hematomaland 2 did not(1 SAH, 1 spontaneous intracerebral hematoma).All patients were treated with phenoba; bital at normal or high doses. Results: 7 patients showed a shoulder-hand syndrome, in 5 patients pain appeared in both shoulders. The time of occurence of this symptoms were from 1 to 6 months. After failure of numerous antalgig treatments , withdrawal or reduction of the barbiturates produced improvement within l-2 weeks in 10 patients, the others 2 patients, required stellate ganglion infiltration. Conclusions: Although affections of the brain, surgical inter ventions, SAHs, motor neurological deficits, can be involved i; the appearance of algodystrophy, in our experience the treatment by barbiturates must be considereda very iqortant etiolcgicalfactor.