Hi, everybody:

I have RSD in my left knee/leg. This knee was operated on seven times already. According to my orthopedic surgeon, I might need another surgery in the same knee. He will know what he has to do only once he opens my knee up. However, he did mention I might need an osteotomy of valgisation, an ACL (Anterior Cruciate Ligament) reconstruction, and a medial meniscus transplant. If he has to do all these operations, I do not know if they can be done in one time, so as to avoid several surgeries.

The RSD pain I have in the left knee that will be operated on is SIP (Sympathetically Independent Pain). I will have general anesthesia so as not to feel any pain and twinges during the surgery. However, I am worried about the post operative pain I know I will undoubtedly feel. I have several questions:

1) Since my RSD pain is sympathetically independent, would a femoral nerve block be effective in controlling my post operative pain? What about other kinds of blocks, such as epidural nerve blocks? I was wondering if all these types of blocks would work since my RSD pain is sympathetically independent.

2) What kinds of pain relief methods could I use to not only control my post operative pain, but also to prevent my RSD and its pain from flaring up? What about pain control during physical therapy?

The anesthesiologists who work in the hospital where I will have my surgery do not know much, if anything, about RSD and its pain, so they cannot really help me, unless some of you have suggestions they could implement.

For the control of the post operative pain after several of my previous knee surgeries, I had a femoral nerve block. Unfortunately, these blocks did not help me very much and I could still feel a lot of pain. I was afraid to mention my pain to the nurses, since every time I did this, they dismissed my pain as being in my mind, probably because they thought the femoral nerve block was taking care of it, despite my denegations.

3) Do you think these femoral nerve blocks were ineffective because my pain was sympathetically independent or because I might have Central Pain Syndrome or centralized pain, according to some anesthesiologists?

4) By the way, what is the difference between Central Pain Syndrome and centralized pain?

Thanks for your information.