Intraoperative Pain Management for Treatment-Resistant Complex Regional Pain Syndrome: A Case Report.
Cureus November 1, 2024 Catherine R La Spina, Patricia Pozo, Gisele J Wakim
Complex regional pain syndrome (CRPS) is a chronic pain disorder that often follows trauma, causing severe pain and autonomic disturbances. Managing CRPS is difficult because no FDA-approved medications exist, and off-label treatments like NSAIDs, corticosteroids, gabapentin, antidepressants, and bisphosphonates have limited or varying efficacy. Surgical options such as nerve blocks and spinal cord stimulation can help but have inconsistent success. A case study describes a patient with a treatment-resistant CRPS flare-up managed through revision neurolysis of the sciatic, tibial, and perineal nerves, release of the right tibial nerve, and intraoperative ketamine.