Abstract
A 50-year-old female experienced complete amputation of the left thumb, index finger and middle finger (zone 3) and a 35 year-old male had complete amputation of the right ring finger (zone 4). In both cases, strong spasms occurred from two days after replantation. The skin temperature fell to below 31°C, and SpO2was around 80%. Therefore, local continuous intra-arterial infusion of Lipo PGE1 was conducted. Lipo PGE1 10μg and heparin 6000 units were dissolved in physiological saline and totaled 48 ml. A 22G catheter was placed into the radial artery, and a syringe pump was used to infuse the solution continuously at a rate of 4-6 mg/h. Immediately after infusion was started, SpO2 improved to over 96% and skin temperature also improved gradually. The catheter was removed after 14 days of infusion, and the replanted fingers survived. Lipo PGE1 is effective in resolving arterial spasm at initial doses of 0.25-0.38 ng/kg/min and a maintenance dose of 0.13 ng/kg/min.
