DOI QR코드

DOI QR Code

Management of Complex Regional Pain Syndrome Type 1 With Total Spinal Block

  • Ok, Se-Jin (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital) ;
  • Yang, Jong-Yeun (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital) ;
  • Son, Ju-Hyung (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital) ;
  • Jeong, Won-Ju (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital) ;
  • Lee, Yoon-Sook (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital) ;
  • Kim, Woon-Young (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital) ;
  • Park, Young-Cheol (Department of Anesthesiology and Pain Medicine, Korea University Ansan Hospital)
  • Received : 2009.10.23
  • Accepted : 2009.12.04
  • Published : 2010.03.01

Abstract

Complex regional pain syndrome (CRPS) is a painful and disabling disorder that can affect one or more extremities. Unfortunately, the knowledge concerning its natural history and mechanism is very limited and many current rationales in treatment of CRPS are mainly dependent on efficacy originated in other common conditions of neuropathic pain. Therefore, in this study, we present a case using a total spinal block (TSB) for the refractory pain management of a 16-year-old male CRPS patient, who suffered from constant stabbing and squeezing pain, with severe touch allodynia in the left upper extremity following an operation of chondroblastoma. After the TSB, the patient’s continuous and spontaneous pain became mild and the allodynia disappeared and maintained decreased for 1 month.

Keywords

References

  1. de Mos M, de Bruijn AG, Huygen FJ, Dieleman JP, Stricker BH, Sturkenboom MC. The incidence of complex regional pain syndrome: a population-based study. Pain 2007; 129: 12-20. https://doi.org/10.1016/j.pain.2006.09.008
  2. Ribbers GM, Geurts AC, Stam HJ, Mulder T. Pharmacologic treatment of complex regional pain syndrome I: a conceptual framework. Arch Phys Med Rehabil 2003; 84: 141-6. https://doi.org/10.1053/apmr.2003.50076
  3. Stanton-Hicks M, Baron R, Boas R, Gordh T, Harden N, Hendler N, et al. Complex regional pain syndromes: guidelines for therapy. Clin J Pain 1998; 14: 155-66. https://doi.org/10.1097/00002508-199806000-00012
  4. Wilder RT. Management of pediatric patients with complex regional pain syndrome. Clin J Pain 2006; 22: 443-8. https://doi.org/10.1097/01.ajp.0000194283.59132.fb
  5. Park JJ, Moon DE, Park SJ, Choi JI, Shim JC. Cervical and thoracic spinal cord stimulation in a patient with pediatric complex regional pain syndrome: a case report. Korean J Pain 2007; 20: 60-5. https://doi.org/10.3344/kjp.2007.20.1.60
  6. Oh HG, Cha YD, Yoon DM. Pain clinic nerve block. Seoul, Koonja Publishing Inc. 1995, pp 71-7.
  7. Kimura T, Komatsu T, Hirabayashi A, Sakuma I, Shimada Y. Autonomic imbalance of the heart during total spinal anesthesia evaluated by spectral analysis of heart rate variability. Anesthesiology 1994; 80: 694-8. https://doi.org/10.1097/00000542-199403000-00032
  8. Goda Y, Kimura T, Goto Y, Kemmotsu O. Power spectral analysis of heart rate and peripheral blood flow variations during total spinal anesthesia. Masui 1989; 39: 1275-81.
  9. Cheon BS, Han KR, Kim JS, Kim YS, Kim C. A case of total spinal anesthesia for treatment of phantom limb pain: a case report. Korean J Pain 2003; 16: 262-6.
  10. Park SY, Han KR, Kim JS, Yoon C, Chae YJ, Kim C. Transient hearing loss following repeated total spinal anesthesias: a case report. Korean J Pain 2003; 16: 282-5.
  11. Yokoyama M, Itano Y, Kusume Y, Oe K, Mizobuchi S, Morita K. Total spinal anesthesia provides transient relief of intractable pain. Can J Anaesth 2002; 49: 810-3. https://doi.org/10.1007/BF03017413
  12. Lee HM, Park HL, Song SO. Functional MRI findings showing cortical reorganization in a patient with type 2 complex regional pain syndrome: a case report. Korean J Anesthesiol 2009; 56: 353-7. https://doi.org/10.4097/kjae.2009.56.3.353

Cited by

  1. Relationship between Complex Regional Pain Syndrome and Working Life: A Korean Study vol.27, pp.8, 2012, https://doi.org/10.3346/jkms.2012.27.8.929
  2. Neuroimaging Studies of Chronic Pain vol.23, pp.3, 2010, https://doi.org/10.3344/kjp.2010.23.3.159
  3. Analysis of the Experiences of Adults with Complex Regional Pain Syndrome vol.9, pp.7, 2010, https://doi.org/10.3390/healthcare9070878