From the Research
The timeline for the triphasic reaction in Complex Regional Pain Syndrome (CRPS) is not directly addressed in the provided evidence, but a triphasic response has been described in the context of postoperative fluid and sodium balance after endoscopic craniopharyngioma resection, with a median time to postoperative diabetes insipidus (DI) of 0.5 hours and a median time to ADH replacement therapy of 4.5 hours in patients with infundibular transection 1. The triphasic reaction, in the context of craniopharyngioma resection, involves a sequence of diabetes insipidus (DI), syndrome of inappropriate antidiuretic hormone secretion (SIADH), and recurrent DI.
- The first phase, DI, begins shortly after surgery, with a median time of 0.5 hours in patients with infundibular transection 1.
- The second phase, SIADH, occurs later, although the exact timing is not well defined in the provided evidence.
- The third phase, recurrent DI, may occur after the resolution of SIADH, although the timing of this phase is also not well defined. It is essential to note that the provided evidence does not directly address the triphasic reaction in CRPS, and the information provided is based on a different medical context.
- However, the study by 1 suggests that the triphasic response can occur in nearly half of infundibular transection cases, and DI begins earlier with infundibular transection.
- The study also suggests that patients can be discharged at or before postoperative day 6 when ADH fluctuations have normalized and endocrinopathy is appropriately managed with oral desmopressin 1. In the context of anaphylaxis, a biphasic reaction is a recurrence of anaphylaxis symptoms within 72 hours of the initial anaphylactic event, without re-exposure to the trigger 2.
- The median time to onset of a biphasic reaction is 7 hours, with a range of 1-72 hours 2.
- Risk factors for biphasic reactions include a history of prior anaphylaxis, unknown precipitant, symptoms of diarrhea, and wheezing 2.