• Scott S Reuben, Erik A Rosenthal, Robert B Steinberg, Shameema Faruqi, and Prasad A Kilaru.
• Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA. scott.reuben@bhs.org
• J Clin Anesth. 2004 Nov 1;16(7):517-22.

Study ObjectivesTo evaluate the efficacy of intravenous regional anesthesia (IVRA) with clonidine in patients with a previous history of complex regional pain syndrome (CRPS) who are undergoing upper extremity hand surgery.DesignProspective, randomized, double-blind study.SettingOperating suites and Pain Management Center of a large university-affiliated medical center.Patients84 patients with a previous history of upper extremity CRPS undergoing surgery on the affected extremity. All signs and symptoms of CRPS had resolved prior to the time of surgery.InterventionsPatients were randomized to receive IVRA with 0.5 % lidocaine with either 1 mL normal saline (n=42) or clonidine 1 microg/kg (n=42) added to the lidocaine solution.MeasurementsRecurrence of CRPS symptoms at 1 year following surgery were recorded.Main ResultsThe recurrence rate of CRPS was significantly lower (p <0.001) in those patients receiving IVRA with lidocaine and clonidine (10%, n=4) compared with those patients receiving IVRA lidocaine only (74%, n=31).ConclusionsIntraoperative IVRA with lidocaine and clonidine on patients with a history of CRPS can significantly reduce the recurrence rate of this disease process.

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