2023, Number 4
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Acta Med 2023; 21 (4)
Complex regional pain syndrome: evaluation and treatment
Hernández PBC, Plancarte SR, López MEC
Language: Spanish
References: 34
Page: 363-367
PDF size: 193.52 Kb.
ABSTRACT
Complex regional pain syndrome (CRPS) is a complex disease whose diagnosis is mainly based on clinical characteristics present at the time of patient evaluation. Currently, the most accepted way to diagnose CRPS is by applying the Budapest criteria. Treatment must be multidisciplinary. Rehabilitation, pharmacological and interventional treatment are the most used options to control the pain and functionality of patients. The main drugs used are oral steroids, anticonvulsants such as carbamazepine and gabapentinoids, and opioids. Interventional treatment includes approaches guided by fluoroscopy, ultrasound, and tomography. For the treatment directed at CRPS of the upper extremity, inhibitions of the sympathetic system in the stellar ganglion and the thoracic sympathetic chain are available, while in the lower extremities, lumbar sympathetic inhibitions are available. Intraaxial analgesia with opioids and clonidine has been suggested to reduce patient pain. Neuromodulation through implantable systems in the posterior cords of the spinal cord and in the dorsal root ganglion offers a promising alternative for patients suffering from this disease.
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