Multidisciplinary pain treatment for complex regional pain syndrome in bilateral upper extremities after median sternotomy: a case report

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  • INOUE Yuka
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • MAEDA Aiko
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital
  • NAKAYAMA Shouko
    Operating Rooms, Kyushu University Hospital
  • YAMAMOTO Misaki
    Operating Rooms, Kyushu University Hospital
  • SHIROUZU Kazuhiro
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine
  • YAMAURA Ken
    Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medicine

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  • 胸骨正中切開後に発症した両側上肢の複合性局所疼痛症候群に対して集学的疼痛治療を行った1症例

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<p>Case: A 68-year-old man underwent cardiac surgery including internal mammary artery dissection using sternal retraction. The day after surgery, he had pain with numbness in the left medial forearm and ulnar side fingers. Two months after surgery, similar symptoms appeared on the right side, gradually, edema and contractures developed in both hands. He was referred to our department 4 months after the surgery. His symptoms, with significant pain and contracture of both hands, met the diagnostic criteria for CRPS. We have performed rehabilitation, pain awareness education, medication, and twelve times ultrasound-guided brachial plexus block (1％ mepivacaine) to control his symptoms. After approximately five months of these treatments, the patient's impeded bilateral upper limbs motion and pain were notably improved. Conclusion: Early multidisciplinary treatment initiation could ameliorate intractable pain syndrome such as complex regional pain syndrome induced by cardiac surgery-related brachial plexus injury.</p>

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