Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.012
Brazilian Journal of Anesthesiology
Case Report

Ultrasound-guided popliteal sciatic nerve block in a pediatric patient with complex regional pain syndrome: a case report

Bloqueio do nervo ciático poplíteo guiado por ultrassom em paciente pediátrico com síndrome dolorosa regional complexa: relato de caso

Patrícia Milena Souza Vinent; Eduardo José Silva Gomes de Oliveira; Caio Márcio Barros de Oliveira; Ed Carlos Rey Moura; Elizabeth Teixeira Noguera Servin; Lyvia Maria Rodrigues de Sousa Gomes; Plinio da Cunha Leal

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Abstract

In the pediatric population, complex regional pain syndrome (CRPS) is a challenging condition that leads to chronic psychosocial dysfunction. This case is of a 12-year-old male patient, 50 kg, who, after twisting his right ankle, started to present intense pain. Without adequate diagnosis and treatment, his family sought a pain specialist. During the evaluation, a change in sensitivity and temperature was observed, besides hyperalgesia, allodynia, redness, edema, and motor dysfunction, being diagnosed with CRPS. Ultrasound-guided sciatic blocks were performed on the affected limb, increasing the interval between crises, reducing pain intensity, and promoting a return to daily activities.

Keywords

Complex regional pain syndrome;  Pain;  Nerve block;  Case report

Resumo

Na população pediátrica, a síndrome de dor regional complexa (SDRC) é uma condição desafiadora que leva à disfunção psicossocial crônica. Este caso é de um paciente do sexo masculino, 12 anos, 50 kg, que após torção do tornozelo direito passou a apresentar dor intensa. Sem diagnóstico e tratamento adequados, sua família procurou um especialista em dor. Durante a avaliação foi observada alteração na sensibilidade e temperatura, além de hiperalgesia, alodinia, vermelhidão, edema e disfunção motora, sendo diagnosticado com SDRC. Foram realizados bloqueios ciáticos guiados por ultrassom no membro afetado, aumentando o intervalo entre as crises, reduzindo a intensidade da dor e promovendo o retorno às atividades diárias.

Palavras-chave

Síndrome complexa de dor regional; Dor; Bloqueio nervoso; Relato de caso

References

1. Everett A, Mclean B, Plunkett A, et al. A unique presentation of complex regional pain syndrome type I treated with a continuous sciatic peripheral nerve block and parenteral ketamine infusion: a case report. Pain Med. 2009;10:1136–9.

2. Barbosa FT, Barbosa TR, Cunha RM, et al. Anatomical basis for sciatic nerve block at the knee level. Rev Bras Anestesiol. 2015;65:177–9.

3. Zernikow B, Wager J, Brehmer H, et al. Invasive treatments for complex regional pain syndrome in children and adolescents: a scoping review. Anesthesiology. 2015;122:699–707.

4. Logan DE, Williams SE, Carullo VP, et al. Children and adolescents with complex regional pain syndrome: more psychologically distressed than other children in pain? Pain Res Manag. 2013;18:87–93.

5. Zorrilla-Vaca A, Li J. Dexamethasone injected perineurally is more effective than administered intravenously for peripheral nerve blocks: a meta-analysis of randomized controlled trials. Clin J Pain. 2018;34:276–84.


Submitted date:
10/23/2020

Accepted date:
07/10/2021

6107ff8ea9539543c10954c4 rba Articles
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Braz J Anesthesiol

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