Anesthetic Management of a Complex Regional Pain Syndrome (CRPS) Patient With Ketamine

Complex regional pain syndrome (CRPS) is a potentially debilitating form of neuropathic pain that may manifest following a traumatic injury or surgery. CRPS is also known as algodystrophy, causalgia, or reflex sympathetic dystrophy (RSD). Patients describe unbearable burning pain from nonnociceptive...

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Bibliographic Details
Published in:Anesthesia progress 2020-12, Vol.67 (4), p.219-225
Main Authors: Mundluru, Tarun, Saraghi, Mana
Format: Article
Language:English
Subjects:
Anesthetics
Burning
Case Reports
Coma
Complex regional pain syndrome
Complex Regional Pain Syndromes - diagnosis
Complex Regional Pain Syndromes - drug therapy
Dentistry
Humans
Intravenous administration
Ketamine
Narcotics
Nervous system
Neuralgia
Nonsteroidal anti-inflammatory drugs
Pain
Pathophysiology
Patients
Quality of life
Reflex Sympathetic Dystrophy
Skin
Tactile stimuli
Trauma
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Description
Summary:Complex regional pain syndrome (CRPS) is a potentially debilitating form of neuropathic pain that may manifest following a traumatic injury or surgery. CRPS is also known as algodystrophy, causalgia, or reflex sympathetic dystrophy (RSD). Patients describe unbearable burning pain from nonnociceptive stimuli, such as when taking a shower or brushing against another object. Regular tactile stimuli encountered during routine dental procedures may not be well-tolerated by a patient with CRPS. Ketamine infusions have been reported to help alleviate acute exacerbations or "flare-ups" of CRPS symptoms. This case report provides a brief overview of CRPS pathophysiology and treatment including data supporting the use of ketamine infusions and a discussion regarding the anesthetic management of a patient with CRPS presenting for dental care under deep sedation utilizing high-dose intravenous ketamine.
ISSN:0003-3006
1878-7177
DOI:10.2344/anpr-67-02-07