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Reflex Sympathetic Dystrophy (RSD and CRPS) Reflex Sympathetic Dystrophy (Complex Regional Pain Syndromes Type I) and Causalgia (Complex Regional Pain Syndromes Type II)(RSD and CRPS)

Having surgery when you have RSD

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Unread 06-08-2008, 11:58 PM   #1
finz
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Default Having surgery when you have RSD

I'm curious to hear stories from those of you with RSD who have required surgery for a non related issue. Have you all had spread to the new area ? Or have some of you escaped that unlucky fate ?

I've researched online and found some info about a preventative "cocktail" using Neurontin and Celebrex to try to avoid the spread of RSD. Has anyone used that with good results ?
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Unread 06-09-2008, 07:41 AM   #2
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Hi, I have never had surgery on a limb that doesn't have RSD but I have had surgery on my leg that does have RSD, it caused some really bad spasms in my leg.
My PM doctor has told me not to have surgery unless I absolutely needed it
Sorry that I can't help you that much
Love Alison
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Unread 06-09-2008, 01:16 PM   #3
dreambeliever128
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Default Hi Finz,

My advice for you is to talk to your Dr. and when you get in the hospital for the surgery talk to the Anesteologist about a block.

The 4 surgeries that I had blocks before, the RSD didnot spread. I had a rotator cuff surgery, ulner nerve, 3 inches of muscle removed under my left arm for TOS and triggerfinger surgery. All 4 times the Dr. agreed that blocks were needed and the Anesteologist are so great about doing them. They know what they are doing. I was already asleep when they did the blocks so I didn't feel them.

Hope this helps and I hope your surgery goes well.

Ada
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Unread 06-10-2008, 06:38 AM   #4
Annie Poo
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I had a hysterectomy last year, and had no problems during or after surgery. Recovery went well. My CRPS was caused by a venipuncture nerve injury in my right arm, so I was nervous that someone might try to put an IV in my right arm while I was out of it. My surgeon told me to have the pre-op nurse write "no IV this arm" on all of the IV sites in my right arm, and that I should tell all of my nurses to make sure they knew what was up.

That's what we did, and everything went well.
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Unread 06-11-2008, 03:12 AM   #5
finz
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Quote:
Originally Posted by dreambeliever128 View Post
My advice for you is to talk to your Dr. and when you get in the hospital for the surgery talk to the Anesteologist about a block.

The 4 surgeries that I had blocks before, the RSD didnot spread. I had a rotator cuff surgery, ulner nerve, 3 inches of muscle removed under my left arm for TOS and triggerfinger surgery. All 4 times the Dr. agreed that blocks were needed and the Anesteologist are so great about doing them. They know what they are doing. I was already asleep when they did the blocks so I didn't feel them.

Hope this helps and I hope your surgery goes well.

Ada
A nerve block to the surgical area ? Do you know what med they used ?
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Unread 06-11-2008, 06:42 AM   #6
dreambeliever128
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Default Hi,

You never said what surgery you had but for me I had Stellette Gangleon Blocks for 3 of the surgeries and when they did the triggerpoint last year they did a bier block.

I honestly don't know what they used, I am thinking lidocaine but those Anesteologist as I said seem to know their stuff. I like them better then PM Drs. for blocks. A lot of them have offices nowadays where they do blocks.

Ada
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Unread 06-11-2008, 11:38 AM   #7
fmichael
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Dear finz -

One of the key techniques in blocking the spread of RSD in sugery is the use of something called "continuous regional anesthesia" during the procedure. The idea is that while a genereal anesthetic knocks you out, only the application of a local to the affected area prevents the flow of pain processing signals to the dorsal horn of the spinal cord, and ultilmately the brain, which in turn may trigger greater sensitization and the spread of RSD.

A good group of articles in pdf formats on the subject appears under the heading of "CRPS and Surgery" on the RSDSA Medical Articles Archive page at http://www.rsds.org/2/library/articl...ve/index.html:
Author: Buvanendran A, Reuben SS, Kari M, Kroin JS, Della Valle C
Title: Perioperative Pregabalin Reduces Neuropathic Pain at 3 Months after Total Knee Arthroplasty (TKA)
Source: Accepted presentation abstract for the International Anesthesia Research Society Meeting, March 2008.

Author: Cramer G, Young BM, Schwarzentraub DPM, Oliva CM, Racs G
Title: Preemptive Analgesia in Elective Surgery in Patients with Complex Regional Pain Syndrome: A Case Report
Source: J Foot Ankle Surg. 2002:39:387-391.

Author: Reuben SS
Title: Preventing the Development of Complex Regional Pain Syndrome after Surgery
Source: Anesthesiol. 2004;101:1215-1224.

Author: Reuben SS, Rosenthal EA, Steinberg RB, Faruqi S, Kilaru P
Title: Surgery on the Affected Upper Extremity of Patients with a History of Complex Regional Pain Syndrome: The Use of Intravenous Regional Anesthesia with Clonidine
Source: J Clin Anes. 2004;16:517-522.

Author: Marx C, Wiedersheim P, Michel BA, Stucki G
Title: Preventing Recurrence of Reflex Sympathetic Dystrophy in Patients Requiring an Operative Intervention at the Site of Dystrophy after Surgery
Source: Clin Rheumatol. 2001;20:114-118
I would definitely check them out.

Mike
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Unread 06-12-2008, 03:12 PM   #8
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Hi again,
Sorry forgot to say when I had my minor operations my doctor did a ring block into my toe and I also had a guanethidine nerve block.
ALISON
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Unread 06-15-2008, 02:54 AM   #9
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i had my appendix taken out while they were trying to find out where my belly pain was comming from after the surgery when i was all heal i still had the pain and got worse thats what made the docter figgure out it was RND (same as RSD just thats the pediatric term for it) i wish i never let them take out my appendix its much worse now.. but its in the same area it hasnt spread its still within the same area
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Unread 06-16-2008, 12:02 AM   #10
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In Nov 2005 I had a e 3 level fusion in my lumbar back. I have had RSD in my feet since 2003, exacerbated in the left by having 2 neuroma's removed cause the podiatrist said that they were causing the pain. I have 2 in the right foot but they are still in there & my left is still worse than the right. Anyway during my back surgery they bathed my spine with Ketamine & I had NO spread to the surgical site. The spine surgeon, anesthesiologist & my PM Doctor talked before my surgery & several times during my surgery. It was a 4 hr surgery. It did take me alot longer to wake from this surgery than from any previous surgery but no other adverse effects from the Ketamine either. No hallucinations etc.

Hope this is helpful.

DebbyV
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