Use of Continuous Regional Anesthesia to Facilitate Aggressive Inpatient Rehab in Children with Complex Regional Pain Syndrome
By Youstina Sawires, MD, Chris Glover, MD, Nihar Patel, MD
Texas Children’s Hospital, Houston, TX, USA
(Summarized and submitted by Nihar Patel, MD)
Complex Regional Pain Syndrome (CRPS) is a difficult to treat disease with physical therapy as the foundation of treatment. Some patients experience pain severe enough to prohibit participation in physical therapy. We report a retrospective case series of nine children with treatment-refractory Complex Regional Pain Syndrome who were treated with regional anesthesia to assist with the initiation of twice-daily, aggressive, inpatient physical therapy (PT).
As evidenced by the fact that all children had functional improvement that was not possible with medical management, regional anesthesia is a viable option for children with CRPS who have failed conservative management and could facilitate rapid, long-lasting recovery. It requires careful patient selection but may be a useful starting point for children who have been unable to participate in outpatient physical therapy due to severe pain.
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