Abstract
A case is described of reflex sympathetic dystrophy (RSD) of the upper limb following cerebral arteriography via the subclavian artery. The pain started in the hand and forearm but, over several weeks, spread to involve the whole arm. After identifying the ulnar nerve in the axillary bundle with a stimulator, a series of small volume injections (bupivacaine 0.5% with epinephrine 2.5 ml and methylprednisolone 40 mg) was given. These relieved the pain and reversed the trophic changes of RSD. It is suggested that this approach is a useful alternative treatment in cases of RSD of the upper extremity.
Résumé
Un cas de dystrophie sympathique réflexe (DSR) du membre supérieur est décrit après artériographie cérebrale via l’artère sousclavière. La douleur a débuté dans la main et l’avantbras mais après plusieurs semaines, elle s’est étendue pour atteindre tout le bras. Après identification du nerf cubital dans le plexus axillaire avec un stimulateur, une série dinjections à petit volume (bupivacaïne 0,5% avec épinéphrine 2,5 ml et méthylprednisolone 40 mg) furent administrées. Ceci a soulagé la douleur et renversé les changements trophiques du RSD. Il est suggéreé que cette approche soit une alternative thérapeutique utile dans les cas de DSR du membre supérieur.
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Klein, D.S., Klein, P.W. Low-volume ulnar nerve block within the axillary sheath for the treatment of reflex sympathetic dystrophy. Can J Anaesth 38, 764–766 (1991). https://doi.org/10.1007/BF03008456
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DOI: https://doi.org/10.1007/BF03008456