The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Is Early Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome Necessary? -A case report-

복합부위통증증후군 제I형 환자에서 조기 척수자극술이 필요한가? -증례보고-

  • Min, Hyoung Ki (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University) ;
  • Han, Kyung Ream (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University) ;
  • Lee, Sang Eun (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University) ;
  • Kim, Kyoung Tae (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University) ;
  • Kim, Chan (Pain Clinic, Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University)
  • 민형기 (아주대학교 의과대학 마취통증의학교실) ;
  • 한경림 (아주대학교 의과대학 마취통증의학교실) ;
  • 이상은 (아주대학교 의과대학 마취통증의학교실) ;
  • 김경태 (아주대학교 의과대학 마취통증의학교실) ;
  • 김찬 (아주대학교 의과대학 마취통증의학교실)
  • Received : 2006.10.10
  • Accepted : 2006.12.01
  • Published : 2006.12.30
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Abstract

Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

Keywords

References

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