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PAIN MEDICINE

The Incidence of Complex Regional Pain Syndrome After Fasciectomy for Dupuytren’s Contracture: A Prospective Observational Study of Four Anesthetic Techniques

Departments of Anesthesiology and Orthopedic Surgery, Baystate Medical Center, Springfield, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts

Address correspondence and reprint requests to Scott S. Reuben, MD, Department of Anesthesiology, Baystate Medical Center, 759 Chestnut Street, Springfield, MA 01199, (413) 794-3520, (413) 794-5349 FAX; email: scott.reuben{at}bhs.org.

The development of complex regional pain syndrome (CRPS) is not an uncommon complication after Dupuytren’s surgery. Despite increasing research interest, little is known regarding which patients are at increased risk for developing CRPS and what is the optimal perioperative treatment strategy for preventing the occurrence of this disease after surgery. We prospectively evaluated the use of four anesthetic techniques (general anesthesia, axillary block, and IV regional anesthesia [IVRA] with lidocaine with or without clonidine) for patients undergoing fasciectomy for Dupuytren’s contracture. All patients were followed in the Pain Management Center at 1, 3, and 12 mo postoperatively by a blinded physician to evaluate the presence of CRPS. Significantly (P < 0.01) more patients developed postoperative CRPS in the general anesthesia group (n = 25; 24%) and the IVRA lidocaine group (n = 12; 25%) compared with either the axillary block group (n = 5; 5%) or the IVRA lidocaine and clonidine group (n = 3; 6%). We conclude that axillary block or IVRA with clonidine offers a significant advantage for decreasing the incidence of CRPS compared with either IVRA with lidocaine alone or general anesthesia for patients undergoing Dupuytren’s surgery.

This article has been cited by other articles:

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				I. T. Awad and F. Chung Factors affecting recovery and discharge following ambulatory surgery: [Les facteurs influencant la recuperation et la sortie apres une operation en chirurgie ambulatoire]. Can J Anesth, September 1, 2006; 53(9): 858 - 872. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999