Korean J Pain.  2006 Dec;19(2):223-227. 10.3344/kjp.2006.19.2.223.

Is Early Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome Necessary?: A case report

• Min HK
• Han KR
• Lee SE
• Kim KT
• Kim C

• KMID: 2073934
• DOI: http://doi.org/10.3344/kjp.2006.19.2.223

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.

Keyword

complex regional pain syndrome; early intervention; spinal cord stimulation

MeSH Terms

Anesthesia, General
Arm
Early Intervention (Education)
Edema
Fingers
Forearm
Hand
Humans
Ketamine
Lidocaine
Nerve Block
Peripheral Nerves
Skin
Spinal Cord Stimulation*
Spinal Cord*
Splints
Subcutaneous Tissue
Sweat
Sweating
Wrist
Young Adult
Ketamine
Lidocaine