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Revista Dor

Print version ISSN 1806-0013

Abstract

OLIVEIRA, Thiago Robis de  and  ANDRADE, Eritson Márcio Fernandes de. Total spinal anesthesia after stellate ganglion block in complex regional painful syndrome patient: case report. Rev. dor [online]. 2013, vol.14, n.2, pp.151-153. ISSN 1806-0013.  http://dx.doi.org/10.1590/S1806-00132013000200016.

BACKGROUND AND OBJECTIVES: Complex regional painful syndrome (CRPS) is a debilitating painful syndrome, with high prevalence in pain management centers. CRPS has several therapeutic options being regional sympathetic block one of the most effective. This study aimed at reporting an uncommon intercurrence of stellate ganglion block in patient with right upper limb CRPS. CASE REPORT: Female patient, 49 years old, physical status ASA I, admitted for management of severe right shoulder burning pain, associated to trophic changes eight months after local trauma. Diagnosis was CRPS and sympathetic stellate ganglion block was indicated. After monitoring, blockade was induced with 0.5% (8 mL) bupivacaine, evolving, after injection in stellate ganglion topography by paratracheal route, with distal limbs paresthesia, anxiety and severe tachydyspnea. Patient was immediately sedated and intubated, remaining in observation for 135 minutes, being then transferred to the post-anesthetic recovery unit (PACU). Three day after procedure, patient reported pain decrease from 10 to 3 according to the visual analog scale. CONCLUSION: Regional blocks are highly effective to manage different pain conditions, including CRPS. This case has shown that, although being uncommon, there might be undesirable effects and the anesthesiologist has to be prepared to adequately support patients in such situations. Adequate understanding of anatomy and of the anesthetic technique decreases the incidence of such effects.

Keywords : Complex regional painful syndrome; Pain; Regional block; Spinal anesthesia; Sympathetic block.

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