Open AccessAppearance of Burning Abdominal Pain During C esarean Section Under Spinal Anesthesia in a Patient with Complex Regional Pain Syndrome: A Case Report
Author(s) -
Kato Jitsu,
Gokan Dai,
Hirose Noriya,
Iida Ryoji,
Suzuki Takahiro,
Ogawa Setsuro
Publication year - 2013
Publication title -
pain medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.893
H-Index - 97
eISSN - 1526-4637
pISSN - 1526-2375
DOI - 10.1111/pme.12004
Subject(s) - medicine , complex regional pain syndrome , anesthesia , allodynia , abdomen , ropivacaine , pain medicine , neuraxial blockade , neuropathic pain , surgery , hyperalgesia , anesthesiology , nociception , spinal anesthesia , receptor
The mechanism of complex regional pain syndrome ( CRPS ) was reported as being related to both the central and peripheral nervous systems. Recurrence of CRPS was, reportedly, induced by hand surgery in a patient with upper limb CRPS . However, there is no documentation of mechanical allodynia and burning abdominal pain induced by C esarean section under spinal anesthesia in patients with upper limb CRPS . Case We report the case of a patient who suffered from burning abdominal pain during C esarean section under spinal anesthesia 13 years after the occurrence of venipuncture‐induced CRPS of the upper arm. The patient's pain characteristics were similar to the pain characteristics of her right arm during her previous CRPS episode 13 years earlier. In addition, mechanical allodynia around the incision area was confirmed after surgery. We provided ultrasound‐guided rectus sheath block using 20 mL of 0.4% ropivacaine under ultrasound guidance twice, which resulted in the disappearance of the spontaneous pain and allodynia. Discussion The pain relief was probably related to blockade of the peripheral input by this block, which in turn would have improved her central sensitization. Conclusion Our report shows that attention should be paid to the appearance of neuropathic pain of the abdomen during C esarean section under spinal anesthesia in patients with a history of CRPS .