Burton Allen W, Hassenbusch Samuel J, Warneke Carla, Racz Gabor, Stanton-Hicks Michael
Department of Anesthesiology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
Pain Pract. 2004 Jun;4(2):74-83. doi: 10.1111/j.1533-2500.2004.04202.x.
There are numerous treatments for complex regional pain syndrome (CRPS). These treatments are varied in scope and include pain management therapies, psychological therapies, and physiotherapy. Treatment guidelines have been published in the past, but little information exists as to how clinicians utilize these guidelines. Moreover, there has been a paradigm shift from the older "reflex sympathetic dystrophy" (RSD) nomenclature, with largely sympathetic block driven diagnosis and therapy to more recent trends towards more inclusive "CRPS" diagnostic criteria and multidisciplinary treatment. There remains controversy regarding the selection of various techniques, and the timing of advancement through the treatment algorithm to the more aggressive, interventional techniques. We set out to determine current CRPS treatment practices of interventional pain specialists.
The authors developed a 36-item, 15-20-minute questionnaire. This questionnaire was sent to 453 interventional pain specialists.
One-hundred-five surveys were returned, with 100 being complete. Eighty-three percent of our respondents were practicing anesthesiology pain specialists who on average treat 14.9 (SD = 16.8) CRPS patients per month.
Our survey results revealed the use of a treatment algorithm for CRPS that consists of treatment using medical therapies (pharmacologic, blocks, catheters, and implantable devices), psychological therapies, and physiotherapy in a coordinated fashion. The trend among our survey respondents is to utilize increasingly interventional techniques after a failed 2- to 4-week trial of any one particular therapy.
复杂区域疼痛综合征（CRPS）有多种治疗方法。这些治疗方法范围各异，包括疼痛管理疗法、心理疗法和物理疗法。过去已发布了治疗指南，但关于临床医生如何使用这些指南的信息却很少。此外，从旧的“反射性交感神经营养不良”（RSD）命名法已发生了范式转变，从主要由交感神经阻滞驱动诊断和治疗转变为最近更具包容性的“CRPS”诊断标准和多学科治疗的趋势。在各种技术的选择以及通过治疗算法推进到更积极的介入技术的时机方面仍存在争议。我们着手确定介入性疼痛专家当前对CRPS的治疗实践。
作者编制了一份包含36个项目、时长15 - 20分钟的问卷。该问卷被发送给453名介入性疼痛专家。
共收回105份调查问卷，其中100份完整。我们的受访者中有83%是从事麻醉学的疼痛专家，他们平均每月治疗14.9（标准差 = 16.8）例CRPS患者。
我们的调查结果揭示了一种针对CRPS的治疗算法的使用情况，该算法以协调的方式包括使用医学疗法（药物、阻滞、导管和植入式装置）、心理疗法和物理疗法进行治疗。我们的调查受访者的趋势是在对任何一种特定疗法进行2至4周的试验失败后，越来越多地使用介入技术。
