Su Yaping, Li Zhenyu, Wang Qian, Tang Hui
Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
Department of Pharmacy, The People's Hospital of Xin Tai City, Taian, China.
Front Neurol. 2023 Aug 14;14:1232199. doi: 10.3389/fneur.2023.1232199. eCollection 2023.
A 14-year-old child was diagnosed with complex regional pain syndrome (CRPS) after bromhidrosis surgery. She experienced a stinging, knife-like, and intermittent attack pain, accompanied by numbness of both upper limbs and limited movements. Ultrasound-guided radiofrequency surgery on the peripheral nerve did not reduce pain. Then, gabapentin 300 mg three times a day and 2% lidocaine by local subcutaneous injection once a day for 3 days were administrated. After the local subcutaneous injection of lidocaine, the pain was significantly relieved, and the pain induced by skin touch at the scar disappeared. No pain recurred after the 1-month follow-up. An evidence-based literature review showed that local or systemic intravenous lidocaine was used to reduce adult CRPS symptoms but less has been reported in children. In our case, a local subcutaneous injection of 2% lidocaine in a child for CRPS treatment was reported to be effective in relieving complex local pain with favorable outcomes. Though further high-quality randomized controlled trials are needed to investigate the effects and safety of local subcutaneous lidocaine injection on pain relief in children with CRPS, it could still provide a relatively safe and effective adjuvant therapy for minor patients.
一名14岁儿童在腋臭手术后被诊断为复杂性区域疼痛综合征(CRPS)。她经历了刺痛、刀割样、间歇性发作的疼痛,伴有双上肢麻木和活动受限。外周神经的超声引导下射频手术未能减轻疼痛。随后,给予加巴喷丁300毫克,每日三次,以及2%利多卡因局部皮下注射,每日一次,共3天。局部皮下注射利多卡因后,疼痛明显缓解,瘢痕处皮肤触摸诱发的疼痛消失。1个月随访后未再出现疼痛。循证文献综述表明,局部或全身静脉注射利多卡因用于减轻成人CRPS症状,但关于儿童的报道较少。在我们的病例中,据报道,局部皮下注射2%利多卡因治疗儿童CRPS可有效缓解复杂的局部疼痛,效果良好。尽管需要进一步高质量的随机对照试验来研究局部皮下注射利多卡因对CRPS儿童疼痛缓解的效果和安全性,但它仍可为未成年患者提供一种相对安全有效的辅助治疗方法。