Document Detail

Hyperbaric oxygen therapy for ischaemia of the hand due to intra-arterial injection of methadone and flunitrazepam.
MedLine Citation:
PMID:  1756884     Owner:  NLM     Status:  MEDLINE    
We present a case of accidental injection of oral methadone and flunitrazepam into the ulnar artery, with resultant severe ischaemia of the hand. Initial therapy consisted of systemic vasodilators, low molecular weight dextran and aspirin. When this therapy failed to produce improvement and amputation of the involved hand seemed inevitable, the patient was referred for hyperbaric oxygen (HBO) therapy. In spite of a 12 day delay in the initiation of HBO, the response was dramatic, with almost complete resolution of the ischaemic signs and symptoms. Intra-arterial injection, which is only rarely encountered in drug addicts, frequently results in severe ischaemia of an extremity, and carries with it a poor prognosis with currently accepted therapy. Given the presently reported experience and the known physiology of HBO, we conclude that HBO should be started early in the treatment of intra-arterial injection of drugs, and should also be considered following prolonged delays.
Y Adir; P Halpern; Z Nachum; H Bitterman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of vascular surgery     Volume:  5     ISSN:  0950-821X     ISO Abbreviation:  Eur J Vasc Surg     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-02-05     Completed Date:  1992-02-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8709440     Medline TA:  Eur J Vasc Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  677-9     Citation Subset:  IM    
Israeli Naval Hyperbaric Institute, Haifa.
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MeSH Terms
Flunitrazepam* / administration & dosage
Hand / blood supply*
Hyperbaric Oxygenation*
Injections, Intra-Arterial / adverse effects
Ischemia / chemically induced,  therapy*
Methadone* / administration & dosage
Substance Abuse, Intravenous / complications*
Reg. No./Substance:
1622-62-4/Flunitrazepam; 76-99-3/Methadone
Comment In:
Eur J Vasc Surg. 1992 May;6(3):338   [PMID:  1592139 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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