Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and succe...Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and successfully treated with supraclavicular brachial plexus catheter infusion of local anesthetic. Case Report: An eight-year-old male underwent a left thoracotomy, repair of esophageal vascular ring, and translocation of the left subclavian to the left carotid artery. Post-operative course was relevant for severe intractable left shoulder and left arm pain associated with allodynia and hyperalgesia. A supraclavicular catheter was inserted, and an infusion of ropivacaine 0.2% was started. The child was sent for physical therapy as he gradually regained all functions of his left arm and resumed his regular activities. Conclusion: Continuous supraclavicular brachial plexus catheter infusion of local anesthetic is a valuable method of reducing pain in severe cases of upper extremity pediatric CRPS and may be safer and more effective than other invasive measures such as sympathetic blocks and epidural catheterization. Further research surrounding the diagnosis and treatment of pediatric CRPS is needed to allow early diagnosis and treatment and to improve outcome.展开更多
On the South Island of New Zealand, Anaesthetists and other Medical Professionals, frequently refer their patients with Complex Regional Pain Syndrome (CRPS) for physiotherapy management. Beliefs about what is importa...On the South Island of New Zealand, Anaesthetists and other Medical Professionals, frequently refer their patients with Complex Regional Pain Syndrome (CRPS) for physiotherapy management. Beliefs about what is important for the management of patients with CRPS are lacking across all medical and allied health disciplines. Difficulties are no gold standard for diagnosis and evidence for intervention methods is moderate or can be conflicting. This paper explores what Physiotherapists believe to be important in a clinical setting for their management of CRPS, as well as documenting and evaluating their interventional methods used in everyday clinical practice across the region of the South Island of New Zealand. This has not been recorded before. Eighty-one Physiotherapists replied to questions on their usual treatment interventions for the management of CRPS, their frequency of use of these treatment interventions, and what they believed to be important in the management of pain and improvement of function. The results demonstrated that CRPS is not a common condition seen regularly by Physiotherapists;that there is a high level of variation between the physiotherapy interventions used and that Physiotherapists’ beliefs regarding interventions used for pain management and functional restoration differ. Education was reported as the most frequently used intervention method. Those physiotherapists seeing CRPS patients more frequently are more likely to use evidence based intervention methods like graded motor imagery or sensory motor training.展开更多
文摘Introduction: Complex regional pain syndrome (CRPS) is a disorder characterized by pain as well as a myriad of sensory, autonomic, and motor disturbances. We are reporting a case of child diagnosed with CRPS and successfully treated with supraclavicular brachial plexus catheter infusion of local anesthetic. Case Report: An eight-year-old male underwent a left thoracotomy, repair of esophageal vascular ring, and translocation of the left subclavian to the left carotid artery. Post-operative course was relevant for severe intractable left shoulder and left arm pain associated with allodynia and hyperalgesia. A supraclavicular catheter was inserted, and an infusion of ropivacaine 0.2% was started. The child was sent for physical therapy as he gradually regained all functions of his left arm and resumed his regular activities. Conclusion: Continuous supraclavicular brachial plexus catheter infusion of local anesthetic is a valuable method of reducing pain in severe cases of upper extremity pediatric CRPS and may be safer and more effective than other invasive measures such as sympathetic blocks and epidural catheterization. Further research surrounding the diagnosis and treatment of pediatric CRPS is needed to allow early diagnosis and treatment and to improve outcome.
文摘On the South Island of New Zealand, Anaesthetists and other Medical Professionals, frequently refer their patients with Complex Regional Pain Syndrome (CRPS) for physiotherapy management. Beliefs about what is important for the management of patients with CRPS are lacking across all medical and allied health disciplines. Difficulties are no gold standard for diagnosis and evidence for intervention methods is moderate or can be conflicting. This paper explores what Physiotherapists believe to be important in a clinical setting for their management of CRPS, as well as documenting and evaluating their interventional methods used in everyday clinical practice across the region of the South Island of New Zealand. This has not been recorded before. Eighty-one Physiotherapists replied to questions on their usual treatment interventions for the management of CRPS, their frequency of use of these treatment interventions, and what they believed to be important in the management of pain and improvement of function. The results demonstrated that CRPS is not a common condition seen regularly by Physiotherapists;that there is a high level of variation between the physiotherapy interventions used and that Physiotherapists’ beliefs regarding interventions used for pain management and functional restoration differ. Education was reported as the most frequently used intervention method. Those physiotherapists seeing CRPS patients more frequently are more likely to use evidence based intervention methods like graded motor imagery or sensory motor training.
