Does failed natural opioid modulation in regional sympathetic ganglia cause reflex sympathetic dystrophy?

Early features of reflex sympathetic dystrophy in a limb resemble the general effects of autonomic arousal associated with opioid withdrawal. It is suggested that natural opioid peptide modulation in regional sympathetic ganglia normally rises to prevent excessive autonomic activity in an injured li...

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Bibliographic Details
Published in:The Lancet (British edition) 1991-11, Vol.338 (8775), p.1125-1127
Main Author: Hannington-Kiff, J.G.
Format: Article
Language:English
Subjects:
Arousal
Autonomic Nerve Block
Biological and medical sciences
Drug toxicity and drugs side effects treatment
Drugs
Dystrophy
Endorphins - metabolism
Ganglia
Ganglia, Sympathetic - metabolism
Health care
Heroin
Humans
Injury prevention
Medical disorders
Medical research
Medical sciences
Miscellaneous (drug allergy, mutagens, teratogens...)
Modulation
Narcotics
Opioids
Pain
Pharmacology. Drug treatments
Preservation
Reflex sympathetic dystrophy
Reflex Sympathetic Dystrophy - etiology
Reflex Sympathetic Dystrophy - prevention & control
Stellate Ganglion - metabolism
Sympathetic ganglia
Wounds and Injuries - complications
Wounds and Injuries - metabolism
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Summary:Early features of reflex sympathetic dystrophy in a limb resemble the general effects of autonomic arousal associated with opioid withdrawal. It is suggested that natural opioid peptide modulation in regional sympathetic ganglia normally rises to prevent excessive autonomic activity in an injured limb. After an injury (especially a trivial one) to a susceptible subject, this localised increase in opioid modulation may fail or may rapidly wane so that autonomic features of opioid withdrawal appear in the affected limb. Florid dystrophic changes may then occur because of passive complications of disuse associated with pain, or as a result of more active processes. Preservation of an appropriate opioid bias in the regional sympathetic ganglia might be an important factor in the successful management and prevention of reflex sympathetic dystrophy.
ISSN:0140-6736
1474-547X
DOI:10.1016/0140-6736(91)91974-Y