2000
DOI: 10.1016/s0952-8180(99)00126-9
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Complex regional pain syndrome (CRPS) with resistance to local anesthetic block: a case report

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Cited by 9 publications
(6 citation statements)
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“…The pain was mainly concentrated in the upper and lower limbs and affected the patients' normal life. Of the two children, one received a 5% lidocaine local patch ( 10 ) and the other received a local block of 0.5% lidocaine 15 mL and 0.25% bupivacaine 20 mL, followed by an intravenous infusion of 250 mg lidocaine ( 11 ). Among the six adult patients, a 26-year-old patient was given intravenous medication at 1–2mg/kg/h for 4 h ( 12 ), one patient was given 5% lidocaine ointment three times a day ( 13 ), and four patients were given a local block therapy with combination medication ( 11 , 14 16 ).…”
Section: Discussionmentioning
confidence: 99%
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“…The pain was mainly concentrated in the upper and lower limbs and affected the patients' normal life. Of the two children, one received a 5% lidocaine local patch ( 10 ) and the other received a local block of 0.5% lidocaine 15 mL and 0.25% bupivacaine 20 mL, followed by an intravenous infusion of 250 mg lidocaine ( 11 ). Among the six adult patients, a 26-year-old patient was given intravenous medication at 1–2mg/kg/h for 4 h ( 12 ), one patient was given 5% lidocaine ointment three times a day ( 13 ), and four patients were given a local block therapy with combination medication ( 11 , 14 16 ).…”
Section: Discussionmentioning
confidence: 99%
“…Of the two children, one received a 5% lidocaine local patch ( 10 ) and the other received a local block of 0.5% lidocaine 15 mL and 0.25% bupivacaine 20 mL, followed by an intravenous infusion of 250 mg lidocaine ( 11 ). Among the six adult patients, a 26-year-old patient was given intravenous medication at 1–2mg/kg/h for 4 h ( 12 ), one patient was given 5% lidocaine ointment three times a day ( 13 ), and four patients were given a local block therapy with combination medication ( 11 , 14 16 ). Except for one patient who received a systemic infusion of lidocaine and ketamine without any pain relief ( 17 ), all the other patients achieved varying degrees of pain relief, of which two patients did not achieve sustained pain relief ( 11 , 12 ).…”
Section: Discussionmentioning
confidence: 99%
“…SCS). Over the last decade, only one other case of CRPS with resistance to local anesthetic blocks has been reported, involving a 12-year-old girl suffering from CRPS-1 of the right ankle 30 . The mechanism of resistance to anesthetic blocks is currently unknown.…”
Section: Discussionmentioning
confidence: 99%
“…The mechanism of resistance to anesthetic blocks is currently unknown. The authors of this report, Maneksha et al 30 , proposed that changes in the dorsal horn cells of the spinal cord, secondary to activation of N-methyl-D-aspartate (NMDA) receptors, may play a role in the pathophysiology of this pain syndrome. Our case provides further support for the importance of neural changes associated with CRPS-1.…”
Section: Discussionmentioning
confidence: 99%
“…Despite most regional anesthesia negligence claims being associated with transient neurologic injuries from peripheral nerve block placement, the major cause of death and/or hypoxic brain injury are due to the deleterious effects from local anesthetic toxicity [29, [38][39][40][41][42]. Varying degrees of local anesthetic drug effectiveness and occasions of decreased sensitivity to certain locals is known to occur in patients with chronic pain [43,44]. Varying degrees of local anesthetic drug effectiveness and occasions of decreased sensitivity to certain locals is known to occur in patients with chronic pain [43,44].…”
Section: Regional Anesthesia In Chronic Pain Patients: Other Relativementioning
confidence: 99%