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Old 06-11-2008, 11:38 AM
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fmichael fmichael is offline
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Join Date: Sep 2006
Location: California
Posts: 1,239
15 yr Member
fmichael fmichael is offline
Senior Member
fmichael's Avatar
 
Join Date: Sep 2006
Location: California
Posts: 1,239
15 yr Member
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Dear finz -

One of the key techniques in blocking the spread of RSD in sugery is the use of something called "continuous regional anesthesia" during the procedure. The idea is that while a genereal anesthetic knocks you out, only the application of a local to the affected area prevents the flow of pain processing signals to the dorsal horn of the spinal cord, and ultilmately the brain, which in turn may trigger greater sensitization and the spread of RSD.

A good group of articles in pdf formats on the subject appears under the heading of "CRPS and Surgery" on the RSDSA Medical Articles Archive page at http://www.rsds.org/2/library/articl...ve/index.html:
Author: Buvanendran A, Reuben SS, Kari M, Kroin JS, Della Valle C
Title: Perioperative Pregabalin Reduces Neuropathic Pain at 3 Months after Total Knee Arthroplasty (TKA)
Source: Accepted presentation abstract for the International Anesthesia Research Society Meeting, March 2008.

Author: Cramer G, Young BM, Schwarzentraub DPM, Oliva CM, Racs G
Title: Preemptive Analgesia in Elective Surgery in Patients with Complex Regional Pain Syndrome: A Case Report
Source: J Foot Ankle Surg. 2002:39:387-391.

Author: Reuben SS
Title: Preventing the Development of Complex Regional Pain Syndrome after Surgery
Source: Anesthesiol. 2004;101:1215-1224.

Author: Reuben SS, Rosenthal EA, Steinberg RB, Faruqi S, Kilaru P
Title: Surgery on the Affected Upper Extremity of Patients with a History of Complex Regional Pain Syndrome: The Use of Intravenous Regional Anesthesia with Clonidine
Source: J Clin Anes. 2004;16:517-522.

Author: Marx C, Wiedersheim P, Michel BA, Stucki G
Title: Preventing Recurrence of Reflex Sympathetic Dystrophy in Patients Requiring an Operative Intervention at the Site of Dystrophy after Surgery
Source: Clin Rheumatol. 2001;20:114-118
I would definitely check them out.

Mike
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