ESRA Academy. Çok OY. Sep 8, 2016; 138524; 0389 Topic: Chronic Pain Management
Assoc. Prof. Oya Yalçın Çok
Assoc. Prof. Oya Yalçın Çok

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Background and Aims:

Complex regional pain syndrome (CRPS) is a chronic pain condition in which diagnosis isbased on clinical features such as disproportionate distal-limb pain, allodynia, hyperalgesia, decreased jointmotion, trophic and vasomotor changes. Patientswith symptoms suggesting development of CRPS may significantly benefit from an earlyinvasive treatment at transition period from acute to chronic phasewhile progressing from peripheral neurogenic inflammation to central sensitization.Here, we report a patient successfully treated with repeated stellate ganglionblockade (SGB) at early stages of probable CRPS development.


52 years-old, female patientwas referred to pain clinic due to persistent and severe pain in left upper armand decreased joint motion for two years. She was consulted by related departments,but no triggering pathology was found. She had physical and medical therapywithout recovery. Her initial pain score(NRS) was 9-10 with severe allodynia.Very mild oedema and discoloration in the hand was observed during the last 2weeks. 


Initial treatment included SGBwith 7mL 1% lidocaine for pain and sudomotor alterations and suprascapularblockade with 10mL 1% lidocaine and 8mg dexamethasone for joint pain underfluoroscopy/ultrasonography guidance. Thereafter, her NRS was 5 and jointmovement recovered in 50%. Solely SGB were performed at second and third visits.Oedema/discoloration ceased completely. Pain was present only while strechingbackwards with NRS of 1-2 for 5months until this report was written. 


Although evidence for the efficacy of SGB for treatment of CRPS isscarce, we suggest that individualized treatment for early onset CRPS symptomsmay successfully include SGB.

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