Kathy I can't at this moment find the 2000 paper, first as far as I know that said the use of pre-emptive analgesics prevented the spread of RSd during operations but I would suggest you print this out and insist he read it. Te full page is here. http://journals.lww.com/anesthesiolo...&type=fulltext

Timing of Surgery
Surgery on an extremity affected with CRPS is generally avoided because of the risk that the symptoms will recur or worsen.29–31 Unfortunately, as many as 6–10% of patients with CRPS may require surgery on the affected extremity.32 The optimal time to perform surgery in patients with a history of CRPS remains unknown and may also affect the recurrence rate. Lankford29 states that sympathetic blocks be performed and the RSD process must be allowed to “cool down” for at least 1 yr, during which time the patient should actively engage in physical therapy before any surgical procedure. For surgical procedures on the knee, Katz and Hungerford30 suggest that care should be taken to “wait until symptoms of reflex sympathetic dystrophy have subsided.” They also recommend physiotherapy and analgesic support with sympatholytic pharmacologic agents and sympathetic blocks before any surgical procedure. The mean time interval reported between resolution of CRPS symptoms and the first procedure to correct mechanical derangement of the knee was 5 months (range, 2–17 months). Under these conditions, 8 of 17 patients (47%) had recurrence of CRPS after surgery. Veldman and Goris31 “preferred to wait until the signs and symptoms of RSD decreased at rest and perfusion of the affected limb was optimized.” These authors emphasized that “surgery in the setting of a cold and/or edematous limb is contraindicated.” They recommended treating CRPS patients with peripheral vasodilators or blockade of the sympathetic nervous system to increase blood flow until skin temperature was normal before any surgical intervention. The authors did not specify the time interval before surgery, but the recurrence rate of CRPS was only 13% (6 of 47 patients). In postarthroplasty patients with CRPS, Katz et al.16 state that elective surgery to correct coexistent mechanical dysfunction (aseptic loosening, ligament imbalance, component malalignment) should be delayed until CRPS symptoms are “under good control.” The investigators recommended that these CRPS patients undergo a series of sympathetic blocks before the anticipated surgery.
It may be clinically useful to assess distress and pain intensity preoperatively in patients presenting for surgery without a history of CRPS. Preoperative pain has been shown to be a predictor of chronic pain after a variety of surgical procedures.33 Patients with greater pain before total joint arthroplasty were found to be at greater risk for heightened postoperative pain, irrespective of confounding issues, such as severity of preoperative disease or postoperative complications.14,34,35 Greater preoperative pain intensity could alter central nociceptive processing pathways, thereby leading to a greater likelihood of development of postsurgical CRPS.36 This theory was recently confirmed in a prospective study that demonstrated that patients presenting with increased preoperative pain had a higher predilection for the development of postoperative CRPS after total knee arthroplasty.14 Harden et al.14 suggested that it may be clinically useful to assess the intensity of pain preoperatively and, if it is increased, to implement appropriate interventions before surgery and to monitor such patients more closely for possible postoperative CRPS.
Although the consensus among physicians in the medical community is to wait for the signs and symptoms of CRPS to resolve before performing surgery, there is no evidence-based medical research to support this theory. Increased preoperative pain has been shown to play a significant role in the development of CRPS after total knee arthroplasty. Future prospective studies are needed to determine whether this holds true for other surgical procedures and whether reducing preoperative pain can decrease the incidence of postsurgical CRPS.
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Regional Blocks
It has been recommended that CRPS patients undergoing surgery should avoid general anesthesia because the disease process might be “rekindled by surgery under general anesthesia.”37 It has been postulated that regional anesthesia, by allowing the preoperative onset of sympathetic blockade, may be a more appropriate anesthetic choice for patients with sympathetically maintained pain because it may prevent the recurrence of this syndrome in the postoperative period.38 Several authors37,38 have reported cases in which patients with previous CRPS had recurrence during general but not regional anesthesia after surgical procedures. The regional techniques used were epidural anesthesia for lower extremity surgery and brachial plexus blockade for upper extremity surgery. It is important to realize that both of these regional techniques are associated with the preoperative onset of a sympathetic blockade, which could prevent the development of CRPS. The use of stellate ganglion block, intravenous regional block, and epidural block have all been reported as techniques that may be useful in decreasing the incidence of postoperative CRPS.