Hi Mfrancis.Palmer

I don't know what country you live in but if I were you I'd either insist on a second opinion or refuse the surgery unless it is a life-threatening emergency. The protocols and guidance (such as it is) is clear about the risk of surgery in any patient with CRPS and the correct procedures to minimise it. Perhaps you might want to mention to the surgeon that you will regard his actions as gross negligence unless he follows the guidance for dense regional anaesthesia before, during and after surgery for adequate lengths of time. I suggest you photocopy and give the surgeon all of the relevant information you can find with the guidance in it - that way he can't claim ignorance either.

The idea that the foot should not be numb until he sees if the CRPS flares up seems insane. Personally I don't think the surgery is worth the risk at least until you get a good quality second opinion from someone other than an orthpaedic surgeon. Get one from someone with a special interest and genuine knowledge about CRPS - say, a neurologist or pain management specialist. Ortho's thypically have no idea and no real interest in CRPS type issues - they just want to get on with the cutting, sawing and hammering!!