Dear Debbie -

As to surgery and CRPS, you can find some articles on the RSDSA site here: http://www.rsds.org/researchlibrary.html#Surgery. Unfortunately, there's a big hole in the middle where Scott Reuben, MD used to be, before he pleaded guilty to a single count of fabricating results of studies aimed at showing that pretreatment with COX-2 NSAIDs would improve post-op recoveries. Check out these links, among others: http://www.circare.org/lex/10cr30002_1_20100114.pdf and http://www.medpagetoday.com/PublicHe...y/Ethics/17985 , apparently in return for various gratuities from a couple of major drug manufacturers.

The problem is that while Reuben’s COX-s papers were clearly frauds, he also acknowledged cooking his own results in a number of multi-center studies in which he was only one author, thereby getting a total of 21 articles withdrawn. http://www.medpagetoday.com/Surgery/...esiology/13592 As such, this left a particular gap where a bunch of good articles - in which he happened to be a co-author – had showed that the use of regional blocks at the surgery site (including continuous regional anesthesia) had a dramatic effect in reducing the spread of post-surgical CRPS. So the articles are - essentially - no more, although a Google search of "Reuben surgery CRPS" still brings a lot of them up. Thus far, these studies have not been replicated and reported post-Reuben. My guess is that the grant money just isn’t there.

That said, everything I’ve heard from my pain doc – chief of pain medicine at a large regional medical school – is that people are continuing to follow the practice of blocks for the areas undergoing surgery. The problem, however, is that in order to arrange it, you have to have a pre-surgical consultation the anesthesiologist, something (at least in Los Angeles) that’s only available at a university medical school. Elsewhere, the anesthesiologist is assigned generally the day before surgery and there is no chance to set anything up.

As far as IVIG is concerned, that’s a long story. Please check out the thread New trauma, new fears and my post no. 8 at http://neurotalk.psychcentral.com/sh...d.php?p=694424

At least that’s what I know.

Mike