gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

Successful treatment of paediatric lower limb CRPS by continuous epidural anaesthesia: a report of 2 cases

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  • presenting/speaker Andrzej Zyluk - Pomeranian Medical University, Szczecin, Poland

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-442

doi: 10.3205/19ifssh0054, urn:nbn:de:0183-19ifssh00548

Published: February 6, 2020

© 2020 Zyluk.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

Objectives/Interrogation: CRPS occurs in children less frequently than in adults, but in the last two decades it has become a well-established entity in children and adolescents. The symptomatology, course, responsiveness to treatment and prognosis of the paediatric disease is also different from the "adult" form.

Methods: The paper presents the successful treatment of two cases of paediatric CRPS involving the lower limb, by continuous epidural anaesthesia with bupivacaine. Both patients developed the condition after minor trauma or overuse. CRPS diagnosis was based on clinical grounds. Both patients presented a history of psychological distress, due to familial problems.

Results and Conclusions: In one patient, the initial treatment was lumbar sympathetic block, resulting in immediate and complete recovery. After relapse of the disease at four months, the next intervention included continuous epidural infusion of bupivacaine, with an excellent and rapid response. In the 2nd case, continuous epidural infusion was used primarily with the same, excellent and fast result.

Clinical peculiarities, treatment modalities and other aspects of paediatric CRPS are discussed. Poor awareness of the condition in the paediatric community is emphasized.