Abstract
Complex regional pain syndrome (CRPS) is a devastating condition often seen after extremity injury and surgery. Prevention of this pathology is attractive not only to patients but also to healthcare providers, as the management of this condition when it becomes chronic can be difficult. One of the safest and efficacious regimens which can be used to prevent occurrence of CRPS in patients with extremity surgery and trauma is the use of daily, high-dose vitamin C for several weeks. A daily dose of more than 500 mg has been recommended by clinical studies, a systematic review with meta-analysis, and a multidisciplinary guideline. Efficacy and safety of vitamin C used to prevent CRPS are discussed.
This is a preview of subscription content, log in via an institution to check access.
Abbreviations
- CRPS:
-
Complex regional pain syndrome
References
Allen G, et al. Epidemiology of complex regional pain syndrome: a retrospective chart review of 134 patients. Pain. 1999;80(3):539–44.
Anderson DJ, Fallat LM. Complex regional pain syndrome of the lower extremity: a retrospective study of 33 patients. Foot Ankle Surg. 1999;38(6):381–7.
Besse JL, et al. Effect of vitamin C on prevention of complex regional pain syndrome type I in foot and ankle surgery. Foot Ankle Surg. 2009;15(4):179–82.
Campbell Jr GD, et al. Letter: ascorbic acid-induced hemolysis in G-6-PD deficiency. Ann Intern Med. 1975;82(6):810.
Cazeneuve JF, et al. Vitamin C and prevention of reflex sympathetic dystrophy following surgical management of distal radius fractures. Acta Orthop Belg. 2002;68(5):481–4.
Chapurlat RD, et al. Dual energy X-ray absorptiometry in patients with lower limb reflex sympathetic dystrophy syndrome. J Rheumatol. 1996;23(9):1557–9.
Chelimsky TC, et al. Value of autonomic testing in reflex sympathetic dystrophy. Mayo Clin Proc. 1995;70(11):1029–40.
Davidoff G, et al. Predictive value of the three-phase technetium bone scan in diagnosis of reflex sympathetic dystrophy syndrome. Arch Phys Med Rehabil. 1989;70(2):135–7.
Harden RN. A clinical approach to complex regional pain syndrome. Clin J Pain. 2000;16(2 Suppl):S26–32.
Harden RN, et al. Complex regional pain syndrome: are the IASP diagnostic criteria valid and sufficiently comprehensive? Pain. 1999;83(2):211–19.
Harris J, et al. Characteristic trends of lower-extremity complex regional pain syndrome. J Foot Ankle Surg. 2004;43(5):296–301.
Lawton JM, et al. Acute oxalate nephropathy after massive ascorbic acid administration. Arch Intern Med. 1985;145(5):950–1.
Lee KJ, Kirchner JS. Complex regional pain syndrome and chronic pain management in the lower extremity. Foot Ankle Clin. 2002;7(2):409–19.
McAllister CJ, et al. Renal failure secondary to massive infusion of vitamin C. JAMA. 1984;252(13):1684.
Padayatty SJ, et al. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010;5(7):e11414.
Perez RS, et al. Physicians’ assessments versus measured symptoms of complex regional pain syndrome type 1: presence and severity. Clin J Pain. 2005;21(3):272–6.
Perez RS, et al. Diagnostic criteria for CRPS I: differences between patient profiles using three different diagnostic sets. Eur J Pain. 2007;11(8):895–902.
Perez RS, et al. Evidence based guidelines for complex regional pain syndrome type 1. BMC Neurol. 2010;10:20.
Rees DC, et al. Acute haemolysis induced by high dose ascorbic acid in glucose-6-phosphate dehydrogenase deficiency. BMJ. 1993;306(6881):841–2.
Sandroni P, et al. Complex regional pain syndrome type I: incidence and prevalence in Olmsted county, a population-based study. Pain. 2003;103(1–2):199–207.
Schurmann M, et al. Imaging in early posttraumatic complex regional pain syndrome: a comparison of diagnostic methods. Clin J Pain. 2007;23(5):449–57.
Schweitzer ME, et al. Reflex sympathetic dystrophy revisited: MR imaging findings before and after infusion of contrast material. Radiology. 1995;195(1):211–14.
Shibuya N, et al. Efficacy and safety of high-dose vitamin C on complex regional pain syndrome in extremity trauma and surgery–systematic review and meta-analysis. J Foot Ankle Surg. 2013;52(1):62–6.
Todorovic-Tirnanic M, et al. Diagnostic approach to reflex sympathetic dystrophy after fracture: radiography or bone scintigraphy? Eur J Nucl Med. 1995;22(10):1187–93.
van de Vusse AC, et al. Interobserver reliability of diagnosis in patients with complex regional pain syndrome. Eur J Pain. 2003;7(3):259–65.
Veldman PH, et al. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993;342(8878):1012–16.
Vogel T, et al. Sympathetic dysfunction in long-term complex regional pain syndrome. Clin J Pain. 2010;26(2):128–31.
Wong K, et al. Acute oxalate nephropathy after a massive intravenous dose of vitamin C. Aust N Z J Med. 1994;24(4):410–11.
Zollinger PE, et al. Effect of vitamin C on frequency of reflex sympathetic dystrophy in wrist fractures: a randomised trial. Lancet. 1999;354(9195):2025–8.
Zollinger PE, et al. Can vitamin C prevent complex regional pain syndrome in patients with wrist fractures? A randomized, controlled, multicenter dose-response study. J Bone Joint Surg Am. 2007;89(7):1424–31.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer Science and Business Media New York (outside the USA)
About this entry
Cite this entry
Shibuya, N., Agarwal, M.R., Jupiter, D.C. (2014). Vitamin C, Extremity Trauma, and Surgery. In: Rajendram, R., Preedy, V., Patel, V. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8503-2_128-1
Download citation
DOI: https://doi.org/10.1007/978-1-4614-8503-2_128-1
Received:
Accepted:
Published:
Publisher Name: Springer, New York, NY
Online ISBN: 978-1-4614-8503-2
eBook Packages: Springer Reference MedicineReference Module Medicine