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Regional Intravenous Guanethidine for Sympathetic Blockade
  1. Edith R. Kepes, M.D.,
  2. Stephen S. Raj, M.D.,
  3. Rao Vemulapalli, M.D.,
  4. Parakulam S. Thomas, M.D. and
  5. Ronald Kaplan, M.D.
  1. From the Pain Treatment Center, Department of Anesthesiology, Montefiore Hospital and Medical Center, Bronx, New York


Regional intravenous guanethidine (RIG) was introduced in countries where the injectable form is available as a substitute for sympathetic nerve block to the extremities. Based on experience with ten patients (eight suffering from reflex sympathetic dystrophy, one from arterial insufficiency and one from frostbite) RIG appears to be longer lasting while avoiding the complications. RIG should be performed only by those familiar with the Bier regional technique.

  • Dystrophy
  • reflex sympathetic
  • Frostbite
  • Arterial insufficiency
  • Guanethidine
  • regional intravenous
  • Bier technique

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  • Preliminary report given at annual meeting of the American Society of Anesthesiologists, October 1979.

  • Address reprint requests to Dr. Kepes: Department of Anesthesiology, Montefiore Hospital and Medical Center, 111 East 210th Street, Bronx, NY 10467.