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Can J Anaesth. 2010 Feb;57(2):149-66. Favorite
Treatment of complex regional pain syndrome: a review of the
evidence.
Tran de QH, Duong S, Bertini P, Finlayson RJ. Related citations in
Department of Anesthesia, Montreal General Hospital, McGill University, Montreal, H3G 1A4, Quebec, Canada. PubMed
de_tran@hotmail.com Review Local anesthetic
[Cochrane
sympathetic
Database
blockade
Syst for
Rev. 2005]
Abstract
complex regional pain syndrome.
PURPOSE: This narrative review summarizes the evidence derived from randomized controlled trials Review Spinal cord stimulation
pertaining to the treatment of complex regional pain syndrome (CRPS). for [Health
chronic Technol
pain of neuropathic
Assess. 2009]
or
ischaemic origin: systematic
SOURCE: Using the MEDLINE (January 1950 to April 2009) and EMBASE (January 1980 to April Review Ultrasonography and
2009) databases, the following medical subject headings (MeSH) were searched: "Complex stimulating [Can
perineural
J Anaesth.
catheters
2008]
Regional Pain Syndrome", "Reflex Sympathetic Dystrophy", and "causalgia" as well as the key for nerve blocks: a review of the
Review Spinal cord stimulation
words "algodystrophy", "Sudeck's atrophy", "shoulder hand syndrome", "neurodystrophy", for complex regional
[Clin Jpain
Pain. 2003]
"neuroalgodystrophy", "reflex neuromuscular dystrophy", and "posttraumatic dystrophy". Results syndrome: an evidence-based
Review Complex regional pain
were limited to randomized controlled trials (RCTs) conducted on human subjects, written in
syndrome: [Anna review.
Vasc Surg. 2008]
English, published in peer-reviewed journals, and pertinent to treatment.
PRINCIPAL FINDINGS: The search criteria yielded 41 RCTs with a mean of 31.7 subjects per See reviews...
study. Blinded assessment and sample size justification were provided in 70.7% and 19.5% of See all...
RCTs, respectively. Only biphosphonates appear to offer clear benefits for patients with CRPS.
Improvement has been reported with dimethyl sulfoxide, steroids, epidural clonidine, intrathecal
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 baclofen, spinal cord stimulation, and motor imagery programs, but further trials are required. The
Cited by 2 PubMed
available evidence does not support the use of calcitonin, vasodilators, or sympatholytic and
Central articles
neuromodulative intravenous regional blockade. Clear benefits have not been reported with
stellate/lumbar sympathetic blocks, mannitol, gabapentin, and physical/occupational therapy. Complex regional pain syndrome.
[Indian J Plast Surg. 2011]
CONCLUSIONS: Published RCTs can only provide limited evidence to formulate recommendations
for treatment of CRPS. In this review, no study was excluded based on factors such as sample size Complex Regional Pain
justification, statistical power, blinding, definition of intervention allocation, or clinical outcomes. Syndrome (CRPS
[Koreantype-1)
J Pain.in2011]
an
Adolescent Following
Thus, evidence derived from "weaker" trials may be overemphasized. Further well-designed RCTs are
warranted.
Related information
PMID: 20054678 [PubMed - indexed for MEDLINE]
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Treatment of complex
regional pain syndrome: a
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