{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T09:46:27Z","timestamp":1772012787088,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,11,7]],"date-time":"2015-11-07T00:00:00Z","timestamp":1446854400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Evidence suggests that complex regional pain syndrome (<jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>) is a manifestation of microvascular dysfunction. Topical combinations of \u03b12\u2010adrenergic receptor agonists or nitric oxide donors with phosphodiesterase or phosphatidic acid inhibitors formulated to treat microvascular dysfunction have been shown to reduce allodynia in a rat model of <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>\u2010I. Driven by these findings, we assessed the outcomes of <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> patients treated with a compound analgesic cream (<jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>) consisting of ketamine 10%, pentoxifylline 6%, clonidine 0.2%, and dimethyl sulfoxide 6% to 10%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An audit was conducted on 13 <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> patients who trialed the <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>. A detailed report was compiled for each patient which comprised baseline characteristics, including <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> description, previous treatments, and pain scores (numerical pain rating scale; 0 to 10). Recorded outcomes consisted of pain scores, descriptive outcomes, and concurrent medications\/treatments, for which basic analysis was performed to determine the effectiveness of the <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>. Case reports are presented for 3 patients with varying outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine patients (69%) reported pain\/symptom reduction (4.4 \u00b1 2.1 vs. 6.3 \u00b1 1.9) with use of the <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>. Six patients reported sustained benefits after 2 months of <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content> use, and 2 patients reported complete resolution of pain\/symptoms: one had early <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>\u2010I and the other received a partial <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> diagnosis. An otherwise medication refractory and intolerant patient found partial benefit with the <jats:styled-content style=\"fixed-case\">CAC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These results demonstrate promise for this topical combination as a useful treatment in multimodal therapy for patients with <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content>, with the potential to resolve pain\/symptoms in early <jats:styled-content style=\"fixed-case\">CRPS<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12404","type":"journal-article","created":{"date-parts":[[2015,11,8]],"date-time":"2015-11-08T19:45:52Z","timestamp":1447011952000},"source":"Crossref","is-referenced-by-count":18,"title":["A Novel Compound Analgesic Cream (Ketamine, Pentoxifylline, Clonidine, <scp>DMSO<\/scp>) for Complex Regional Pain Syndrome Patients"],"prefix":"10.1111","volume":"16","author":[{"given":"Marc 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