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
Mastocytosis is a rare group of disorders with chronic and episodic mast cell release of mediators which can have systemic and cutaneous manifestations. Triggers of anaphylaxis include commonly used medications for an...Mastocytosis is a rare group of disorders with chronic and episodic mast cell release of mediators which can have systemic and cutaneous manifestations. Triggers of anaphylaxis include commonly used medications for anesthesia, analgesia, and muscle relaxation. There is little in the literature regarding local anesthesia in emergent surgery for patients with mastocytosis. This case details the use of a peripheral nerve blockade for multiple surgeries and pain control in a patient with biopsy-proven mastocytosis.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Mastocytosis is a rare group of disorders with chronic and episodic mast cell release of mediators which can have systemic and cutaneous manifestations. Triggers of anaphylaxis include commonly used medications for anesthesia, analgesia, and muscle relaxation. There is little in the literature regarding local anesthesia in emergent surgery for patients with mastocytosis. This case details the use of a peripheral nerve blockade for multiple surgeries and pain control in a patient with biopsy-proven mastocytosis.
