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Title: A Novel Compound Analgesic Cream (Ketamine, Pentoxifylline, Clonidine, DMSO) for Complex Regional Pain Syndrome Patients
Authors: Russo M 
Santarelli D
Anzca Brief Name: Russo, M 
Keywords: complex regional pain syndrome
nitric oxide
dimethyl sulfoxide
compound analgesic cream
Issue Date: 7-Nov-2015
Source: 16(1):E14-E20
Journal Title: Pain Practice
Abstract: 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.
DOI: 10.1111/papr.12404
PubMed URL:
Type: Journal Article
Affiliates: Hunter Pain Clinic, Broadmeadow, NSW, Australia
Study/Trial: Case Series and Case Reports
Appears in Collections:Scholarly and Clinical

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CAC for CRPS - 2015 - Russo Santarelli (ID 3242) (ID 54788).pdf
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