Bloqueo simpático lumbar para el manejo de síndrome doloroso regional complejo, a propósito de un caso con resolución completa
Lumbar sympathetic blockade for the management of complex regional pain syndrome, apropos of a case with complete resolution

Rev. chil. anest; 52 (1), 2023
Publication year: 2023

Phantom limb syndrome (PLS) is a condition that occurs in amputee patients that has a wide array of different treatment approaches. We present the case of a patient diagnosed with complex regional pain syndrome (CRPS) of the right upper limb secondary to polytrauma with complete brachial plexus injury, who, after being subjected to múltiple successful therapies, was finally taken to amputation. Later, he developed a painful PLS that was difficult to manage, which was treated with a stellate ganglion block (SGB), achieving a significant decrease in pain. This article aims to present a case in which a SGB was used as an adjunct to control acute postoperative PLS in a patient with previous sensitization due to CRPS. The SGB, in this case, performed with local anesthetic plus corticosteroid, constitutes a useful therapeutic alternative for intense postoperative pain in PLS, achieving adequate pain relief without adverse effects. However, its routine use as in acute postoperative pain still lacks sufficient evidence for complete support, therefore we urge the scientific community to undertake more in depth research concerning this topic in order to create clear guidelines and recommendations.
El síndrome doloroso regional complejo (SDRC) es una patología crónica dolorosa, con una prevalencia aproximada de 5,4 a 26,2 por 100.000 personas al año, y se caracteriza por ser un dolor regional espontáneo que empeora progresivamente sin seguir una distribución dermatómica. El dolor experimentado, es desproporcionado en tiempo y gravedad al evento desencadenante, acompañándose de síntomas sensoriales (alodinia, hiperalgesia), vasomotores (cambios de la temperatura cutánea) y tróficos (hipertricosis, descamación). A continuación, se describirá un caso clínico en donde se evidencia una respuesta positiva y prolongada luego de la realización de un bloqueo simpático lumbar, resaltándose la importancia de un diagnóstico oportuno y temprano.

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