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· DOS Abstracts
Complex regional pain syndrome (CRPS) in children
- treatment with peripheral nerve catheter
Søren Bødtker, Søren Anker Pedersen, Lene Larsen, Vibeke Rosenkvist,
Svandhild Ivarsslaten, Mai Pedersen
Orthopaedics, University Hospital Hvidovre; Pediatrics, University Hospital
Hvidovre; Anaestecis, University Hospital Hvidovre; physiotherapy, University
Hospital Hvidovre
Background:
Complex regional pain syndrome (CRPS) is a neuropathic condi-
tion charterized by circular allodynia and functional loss. Treatment with periph-
eral nerve blockade in children and adults has yet only been reported as case
studies.
Purpose / Aim of Study:
This study reports our results and complications on
treatment combining continous pain relieve combined with physio-occupational
therapy in children with CRPS.
Materials and Methods:
Inclusion criterias were circular sensory disturbanc-
es and allodynia, thus loosing ability to self-support on their limb. A catheter
was implanted close to either N. ischiaticus, N. saphenous or brachial plexus.
Implantation was done in GA and guided by EMG and ultrasound. All patients
received a specific and continous pain relieve by Naropin, combined with immidi-
ate physiotherapy and/or occupational therapy with a supplement of 2 hours of
walking. The theraphy focused on improving coordination, strength, and sensory
motor skills
Findings / Results:
16 children were consecutively included (13 girls:3 boys)
with foot pain (13), hand pain (2) and combined foot/hand pain (1). At admis-
sion the average age was 11 years (9-14); average duration of pain were 9
months (2-33) with a VAS score of 9 (7-10). Initiation of pain was either no
(7) or minor trauma (7 distorsions, 1 fracture and 1 surgical induced). After an
average observation period of 12 months (6-37) the VAS score was 0 (0-4).
No relapses, neurological complications or infection occurred during the obser-
vation period.
Conclusions:
Treatment with pain catheter and training seems safe and effec-
tive for children with CRPS, resulting in pain-free or almost pain-free patients.
127.
