-Abstract-
Effects from many different approaches have been made to cure Raynaud's
phenomenon, such as a dorsal sympathectomy, topical injection of nitroglycerin,
phentolamin and procaine, and oral or parentral administration of various drugs.
However, there has been no successful management proven yet.
In recent years, it was reported that intra·arterial administration ill normal subjects
as well as patients with Raynaud's syndrome has demonstrated a significant rise in
blood flow to the lands.
We used intermittent stellate ganglion blocks in conjunction with intra-arterial
injections of reserpine and procaine in 10 patients suffering from finder necrosis. The
stellate gang1ion block was performed in a paratracheal approach by injection of 1%
lidocaine purposely mixed with adrenaline followed by the administration of reserpine 1
㎎ and procaine 50 ㎎ through a butterfly needle inserted in the radial or brachial artery.
The administration of reserpine and procaine was done only twice at intervals of 1
week because of the development of suspected arteriosclerosis. The stellate ganglion
block was carried out once a week for about 3 months, then once a month as needed
for 6 to 12 months. As the procedure was carried out and the necrotic tissue sloughed
off, oozing appeared and new granulation tissue was observed. 5 out of 10 patients were
healed completely and the rest improved considerably but were not followed to the end.
We concluded that the intra-arterial administration of reserpine 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.
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