Annals of the Academy of Medicine, Singapore · 2005
Severe upper limb complications from parenteral abuse of Subutex.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Loo H W, Yam A K T, Tan T C, Peng Y P, Teoh L C
Аннотация
INTRODUCTION: Subutex is a sublingual formulation of buprenorphine that is used to treat opioid dependency. It may be abused parenterally with disastrous consequences.
CLINICAL PRESENTATION: We present 4 cases of parenteral abuse of Subutex resulting in severe upper limb complications.
TREATMENT: Two vascular complications were treated with combinations of anticoagulants, vasodilators, brachial plexus bock and iloprostol. One severe hand abscess required surgical debridement, and 1 median nerve injury required neurolysis.
OUTCOME: All patients had a poor outcome. Both patients with vascular complications required multiple amputations, the patient with a thenar abscess had severely impaired thumb function, and the patient with median nerve injury has ongoing neuralgic pain, numbness and thenar weakness.
CONCLUSION: The incidence of complications of parenteral abuse of Subutex is increasing in Singapore. These complications have a poor outcome despite adequate management, and are best prevented by education or legal means.
CLINICAL PRESENTATION: We present 4 cases of parenteral abuse of Subutex resulting in severe upper limb complications.
TREATMENT: Two vascular complications were treated with combinations of anticoagulants, vasodilators, brachial plexus bock and iloprostol. One severe hand abscess required surgical debridement, and 1 median nerve injury required neurolysis.
OUTCOME: All patients had a poor outcome. Both patients with vascular complications required multiple amputations, the patient with a thenar abscess had severely impaired thumb function, and the patient with median nerve injury has ongoing neuralgic pain, numbness and thenar weakness.
CONCLUSION: The incidence of complications of parenteral abuse of Subutex is increasing in Singapore. These complications have a poor outcome despite adequate management, and are best prevented by education or legal means.