連續性神經阻斷術對於難纏性神經性疼痛治療之病例報告

Continuous Axillary Block Infusion in Patient with Complex RegionalPain Syndrome - Case Report

複雜性區域疼痛症候群（CRPS）是一種神經性導因的疼痛，其特徵含有疼痛、血管運動及失養改變及偶而有活動障礙等表現。其複雜性增加疼痛處理的困難度及障礙。有一個案有外儡病史，其症狀含疼痛過敏、過度疼痛、過度反應及酸麻感等出現。雖然經過不同的治療方式，但仍然沒法獲得滿意的疼痛舒緩，因此疼痛處置方式由間隔投藥轉為連續性投藥方式，所使用的神經阻斷方式為經上鎖骨方向實施臂神經叢阻斷術。經過兩星期的處置，病人對疼痛舒緩感滿意，所以連續性神經阻斷術對於難經性神經性痺痛有利。

Complex regional pain syndrome (CRPS) is a neuropathic pain syndrome which is characterized by pain, vasomotor and dystrophic changes and often motor impairments. Its complexity increased the difficulty and barrier in pain management. A case with trauma history suffered from hyperalgesia, allodynia, hyperpathia and numbness over the involved right palm and fingers. Even though under various modalities of pain management, the patient was still found with great and intolerable pain. The pain management regimen changed from intermittent into continuous mode. The block selected was supra-clavicular brachia! plexus blockade. After 2-week therapy, patient was satisfactory with her pain control. Conclusively, continuous brachia! plexus block was beneficial to the management of CRPS with intractable pain.