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Anesth Analg 2007; 105:1148-1151
© 2007 International Anesthesia Research Society
doi: 10.1213/01.ane.0000278867.24601.a0
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ANALGESIA

Successful Intravenous Regional Block with Low-Dose Tumor Necrosis Factor-{alpha} Antibody Infliximab for Treatment of Complex Regional Pain Syndrome 1

Michael Bernateck, MD*, Roman Rolke, MD{dagger}, Frank Birklein, MD{dagger}, Rolf-Detlef Treede, MD{ddagger}, Matthias Fink, MD§, and Matthias Karst, MD*

From the *Department of Anesthesiology, Pain Clinic, Hannover Medical School; {dagger}Department of Neurology; {ddagger}Institute of Physiology and Pathophysiology, University of Mainz; and §Department of Physical Medicine and Rehabilitation, Hannover Medical School, Germany.

Address correspondence and reprint requests to Michael Bernateck, MD, Hannover Medical School, Department of Anesthesiology, Pain Clinic, Carl-Neuberg-St. 1, 30625 Hannover, Germany. Address e-mail to bernateck.michael{at}mh-hannover.de.

Abstract

Cytokines, particularly tumor necrosis factor-{alpha}, may play an important role in the mediation of mechanical hyperalgesia and autonomic signs in complex regional pain syndrome 1. We performed an IV regional block with low-dose administration of the tumor necrosis factor-{alpha} antibody, infliximab, in a patient with typical clinical signs of complex regional pain syndrome 1 (moderate pain, edema, hyperhidrosis, elevated skin temperature compared with the contralateral side). A significant improvement of clinical variables was observed 24 h after infliximab treatment. Almost complete remission was reached within 8 wk, but sensory signs improved only after 6 mo. No adverse events were observed.






Lippincott, Williams & Wilkins 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 HighWire Press
Copyright © 2007 by the International Anesthesia Research Society.