Raynaud증후군을 위한 Reserpine, Procaine의 동맥주사와 성상교감신경절 차단

Abstract

Efforts from many different approaches have been made to cure Raynaud's phenomenon, such as dorsal sympathectomy, topical injection of nitroglycerin, phentolamin and procaine, and oral or parentr al 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 one patient suffering from bilateral finger necrosis. The stellate ganglion block was performed in a paratracheal approach by injection of 0.75% bupivacaine without epinephrine mixed and followed by the administration of reserpine I mg and procaine 50 mg through a butterfly needle inserted in the radial artery.

The administration of reserpine and procaine was done only one time. The stellate ganglion block was carried out once in a 5 days for about I month, then once in a 2 weeks as needed for 2 months.

As the procedure was carried out and the necrotic tissue sloughed off, oozing appeared and new granulation tissue was observed.

Now the patient was healed completely and he is waiting for revision of the stump.

We concluded that the intra-arterial administration of resrepine 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.