Efficacy and Safety of High-dose Vitamin C on Complex Regional Pain Syndrome in Extremity Trauma and Surgery-Systematic Review and Meta-Analysis

Naohiro Shibuya, Jon M. Humphers, Monica R. Agarwal, Daniel Jupiter

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Complex regional pain syndrome (CRPS) is a devastating condition often seen after foot and ankle injury and surgery. Prevention of this pathology is attractive not only to patients but also to surgeons, because the treatment of this condition can be difficult. We evaluated the effectiveness of vitamin C in preventing occurrence of CRPS in extremity trauma and surgery by systematically reviewing relevant studies. The databases used for this review included: Ovid EMBASE, Ovid MEDLINE, CINAHL, and the Cochrane Database. We searched for comparative studies that evaluated the efficacy of more than 500 mg of daily vitamin C. After screening for inclusion and exclusion criteria, we identified 4 studies that were relevant to our study question. Only 1 of these 4 studies was on foot and ankle surgery; the rest concerned the upper extremities. All 4 studies were in favor of this intervention with minimal heterogeneity (Tau2 = 0.00). Our quantitative synthesis showed a relative risk of 0.22 (95% confidence interval = 0.12, 0.39) when daily vitamin C of at least 500 mg was initiated immediately after the extremity surgery or injury and continued for 45 to 50 days. A routine, daily administration of vitamin C may be beneficial in foot and ankle surgery or injury to avoid CRPS. Further foot and ankle specific and dose-response studies are warranted.

Original languageEnglish (US)
Pages (from-to)62-66
Number of pages5
JournalJournal of Foot and Ankle Surgery
Volume52
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

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Keywords

  • Ascorbic acid
  • Causalgia
  • Chronic pain
  • Reflex sympathetic dystrophy
  • Sudeck's dystrophy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Surgery

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