Anesth Pain Med.  2012 Apr;7(2):196-199.

Development of complex regional pain syndrome at independent arm associated with lateral decubitus position: A case report

• Kang JE
• Cho JH
• Park PE
• Lee YJ
• Kim JH
• Woo NS
• Kim HK

Abstract

A 27-year-old man underwent excision of a mediastinal mass using video-assisted thoracoscopic surgery (VATS) performed in the right lateral position. Postoperatively, he complained of pain in the left upper arm and chest wall, limitation of the left shoulder joint, allodynia, hyperalgesia, spontaneous pain in left finger, edema, hypohidrosis, and change of skin color of the left hand. We diagnosed the patient with complex regional pain syndrome (CRPS) by using the proposed modified International Association of the Study of Pain (IASP) research diagnostic criteria, and initiated treatment through medication and interventional management. After 3 months of treatment, the pain intensity reduced to below 2 cm on the VAS. In this study, we describe a case of postoperative CRPS, which is believed to have been caused by excessive stretching of the brachial plexus. Careful positioning of patients on the operating table with proper padding will reduce injuries to the peripheral nerves.

Keyword

Brachial plexus neuropathy; Complex regional pain syndrome; Lateral decubitus position

MeSH Terms

Adult
Arm
Brachial Plexus
Brachial Plexus Neuropathies
Edema
Fingers
Hand
Humans
Hyperalgesia
Hypohidrosis
Operating Tables
Peripheral Nerves
Shoulder Joint
Skin
Thoracic Surgery, Video-Assisted
Thoracic Wall