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Complex regional pain syndrome following protracted labour *
Author(s) -
Butchart A. G.,
Mathews M.,
Surendran A.
Publication year - 2012
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2012.07301.x
Subject(s) - medicine , anesthesia , weakness , complication , allodynia , foot drop , surgery , gabapentin , magnetic resonance imaging , hyperalgesia , nociception , receptor , radiology , alternative medicine , pathology
Summary Obstetric nerve palsies are common and long‐term sequelae are fortunately rare. The development of a complex regional pain syndrome is an unusual and less reported complication of labour‐related neuropathy. A 28‐year‐old primigravida who experienced prolonged labour and instrumental delivery under spinal anaesthesia complained of persisting weakness and numbness postpartum, affecting the left lower limb. Urgent magnetic resonance imaging demonstrated no abnormality and a common peroneal nerve injury was later confirmed by nerve conduction studies. Unfortunately, the neuropathy did not resolve as expected and oedema, burning paraesthesia and allodynia affecting the left foot developed within two weeks. She was treated with gabapentin, ibuprofen, topical capsaicin and regular physiotherapy. After six months, the foot drop had resolved and the chronic pain element was significantly diminished.