In the case of intra-arterial injection of propoxyphene hydrochloride (Darvon) discussed here, management included dextran 40 in a steady drip, extensive fasciotomy, and secondary excision of necrotic muscle after the wound was maintained open for a week. This produced an excellent functional result. The exploration of the artery, instillation of papauerine hydrochloride, and injection of the adventitia with lidocaine (Xylocaine) was of questionable value. The arteriogram done at the time of initial surgery showed clear areas of blockage of the digital arteries.
Pearlman HS, Wollowick BS, Alvarez EV. Intra-arterial Injection of Propoxyphene Into Brachial Artery. JAMA. 1970;214(11):2055–2057. doi:10.1001/jama.1970.03180110063018