تاثبر بي حسي اپيدورال در كنترل درد و ترميم زخم در مبتلايان به بيماري برگر

THE EFFECT Of EPIDUA AL ANESTHESIA PAIN CONTROL AND WOUND HEALING IN PATIENTS WITH BUERGERʹS DISEASE

Buergerʹs disease is a kind of obstructive vascular disease specially occuring in the lower limbs and appears to have a high prevalence in the eastern countries. Becuse of a lack of knowledge of its definite etiology, its treatment is usually accompanied by multiple amputations and failures. Various methods have been used to control pain and healing of extremitiesʹ wounds in those affected with Buergerʹs disease. the objective of this study was to assess to the degree of efficacy of epidural anesthesia in the control of pain and wound healing in these patients. In this experimental study, 17 patients with Buergerʹs disease were hospitalized in the surgical ward and after conducting the primary consesvative measures, an epidural anesthesia was initiated after placing an epidural catheter and injecting marcaine at intervals of 4 hours. The degree of pain and wound healing were evaluated and compared before and after the procedure and then at 2 weeks interval. 16(94%) patients reported a reduction in pain and warning of extremities soon after placement of the catheter and injection of marcaine. Two weeks later, in 88% of the patients, there had been a relative or absolute improvement in lower extremity wounds. At discharge, 15 patients did not complain of pain and could walk comfortably. 9 of the patients had undergone surgical sympathectomy but had proved invain in controlling the disease. Epidural anesthesia in the acute stage of Buergerʹs disease by speedy reduction in pain can bring about early ambulation if hygenic conditions of the extremity are observeal and thus can prevent the progression of the lesions. Further studies are needed to determine the mechanism and effect of this procedure.