Clinical experience using intrathecal (IT) bupivacaine infusion in three patients with complex regional pain syndrome type I (CRPS‐I)

Lundborg, Christopher; Dahm, Peter; Nitescu, Petre; Appelgren, L.; Curelaru, I

doi:10.1034/j.1399-6576.1999.430613.x

Cited by 29 publications

(15 citation statements)

References 14 publications

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“…There are small case series of efficacy of intrathecal morphine [43]. One small case series found intrathecal bupivicaine to be ineffective [68]. Baclofen is the only intrathecal agent whose efficacy in CRPS is supported significantly in the literature.…”

Section: Treatment Options Using An Indwelling Intrathecal Catheter Amentioning

confidence: 99%

Complex regional pain syndrome: A review of evidence-supported treatment options

Hord

Oaklander

2003

Current Science Inc

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Complex regional pain syndrome consists of pain and other symptoms that are unexpectedly severe or protracted after an injury. In type II complex regional pain syndrome, major nerve injury, often with motor involvement, is the cause; in complex regional pain syndrome I, the culprit is a more occult lesion, often a lesser injury that predominantly affects unmyelinated axons. In florid form, disturbances of vasoregulation (eg, edema) and abnormalities of other innervated tissues (skin, muscle, bone) can appear. Because of these various symptoms and the difficulty in identifying causative lesions, complex regional pain syndrome is difficult to treat or cure. Complex regional pain syndrome has not been systematically investigated; there are few controlled treatment trials for established complex regional pain syndrome. This article reviews the existing studies (even if preliminary) to direct clinicians toward the best options. Treatments for other neuropathic pain syndromes that may be efficacious for complex regional pain syndrome also are discussed. Some common treatments (eg, local anesthetic blockade of sympathetic ganglia) are not supported by the aggregate of published studies and should be used less frequently. Other treatments with encouraging published results (eg, neural stimulators) are not used often enough. We hope to encourage clinicians to rely more on evidence-supported treatments for complex regional pain syndrome.

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Section: Treatment Options Using An Indwelling Intrathecal Catheter Amentioning

confidence: 99%

Complex regional pain syndrome: A review of evidence-supported treatment options

Hord

Oaklander

2003

Current Science Inc

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“…Outcome variables after an amputation such as quality of life have been infrequently reported [8]. Previously, there was insufficient evidence that amputation positively contributes to the treatment of CRPS-I, with just a few published case studies with positive outcomes [2,7,9,10]. Guidelines warn against amputation because of the risk of recurrence of the syndrome due to their referral to one or two larger studies with predominantly negative outcomes [5,[11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Resilience in patients with amputation because of Complex Regional Pain Syndrome type I

Bodde¹,

Schrier²,

Krans³

et al. 2013

Disability and Rehabilitation

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The results confirmed our hypothesis that patients with an amputation because of CRPS-I who have a higher resilience also have a higher quality of life and experience lower psychological distress. The prognostic value of resilience in this patient group requires further research. Implications for Rehabilitation Until characteristics of patients with positive quality of life outcome have been further unraveled, amputation for CRPS-I should only be performed in expertise centers. Resilience, the process of adapting well in the face of adversity, should be further explored in Rehabilitation Medicine research in general. Measurement of resilience should be a standard procedure when patients with CRPS-I request an amputation. Improving resilience of patients in in- and outpatient rehabilitation clinics might be an additional treatment in rehabilitation care.

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“…In the pediatric population, intrathecal infusions have been successfully utilized to treat severe cancer pain and CRPS I . Intrathecal administration of both opioids and local anesthetics has been described in children . Farid and Heiner successfully treated an 8‐year‐old girl with chronic left foot pain by placing an intrathecal catheter at the L4‐5 spinal space and infusing 0.2% ropivacaine at 0.03 mg/kg/h for 1 week .…”

Section: Discussionmentioning

confidence: 99%

Interventional Procedures for Chronic Pain in Children and Adolescents: A Review of the Current Evidence

2015

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This review discusses the role of interventional procedures in the treatment of chronic pain in children and adolescents. Due to lack of scientific evidence, significant controversy surrounds the utility of invasive techniques for managing pediatric chronic pain states. Interventional procedures are a widely accepted modality for pain management in adults. The use of such techniques in children is supported only by case reports, case series, and very few randomized controlled studies. In addition, the potential for severe complications leaves open a debate on the safety of these invasive procedures, which must be confirmed by more extensive and accurate prospective studies.

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Clinical experience using intrathecal (IT) bupivacaine infusion in three patients with complex regional pain syndrome type I (CRPS‐I)

Cited by 29 publications

References 14 publications

Complex regional pain syndrome: A review of evidence-supported treatment options

Complex regional pain syndrome: A review of evidence-supported treatment options

Resilience in patients with amputation because of Complex Regional Pain Syndrome type I

Interventional Procedures for Chronic Pain in Children and Adolescents: A Review of the Current Evidence

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