Kumbhat S, Meyer N, Schurr M J
Department of Surgery, University of Wisconsin Hospital, Madison, USA.
J Burn Care Rehabil. 2004 Mar-Apr;25(2):189-91. doi: 10.1097/01.bcr.0000111768.86660.90.
Complex regional pain syndrome (CRPS) is an unusual complication after burns; however, it is important to recognize so that appropriate treatment can be administered. A 60-year-old man suffered an alkali burn to the right foot. Subsequently, the patient developed CRPS with severe pain and vasomotor changes. Multimodal treatment included the early use of ropivacaine and fentanyl via epidural catheter. Oral extended-release morphine, gabapentin, and amitriptyline also were administered. Once pain was controlled, early aggressive physical therapy was instituted, and attention was turned toward wound coverage. One year after discharge, the patient was ambulating well and has returned to work. His pain was managed with a single morning dose of gabapentin and a nonsteroidal anti-inflammatory agent. Current examination of the foot revealed mild forefoot swelling without residual erythema. Ambiguities exist in the mainstay of treatment for CRPS, but this multimodal method of controlling CRPS after burn injury allowed for control of the patient's pain, early mobilization, and eventual return to work.
复杂性区域疼痛综合征（CRPS）是烧伤后一种罕见的并发症；然而，认识到这一点很重要，以便能够进行适当的治疗。一名60岁男性右脚遭受碱烧伤。随后，该患者发展为CRPS，伴有严重疼痛和血管舒缩变化。多模式治疗包括通过硬膜外导管早期使用罗哌卡因和芬太尼。还给予了口服缓释吗啡、加巴喷丁和阿米替林。一旦疼痛得到控制，就开始早期积极的物理治疗，并将注意力转向伤口覆盖。出院一年后，患者行走良好并已重返工作岗位。他的疼痛通过每天早上单次服用加巴喷丁和一种非甾体抗炎药得到控制。目前对足部的检查显示前足轻度肿胀，无残留红斑。CRPS的主要治疗方法存在一些不明确之处，但这种烧伤后控制CRPS的多模式方法能够控制患者的疼痛、早期活动，并最终使其重返工作岗位。
