A case of complex regional pain syndrome type II after transradial coronary intervention.
The transradial approach for coronary catheterization is now a routine technique without serious complications at the puncture site. We report a case of complex regional pain syndrome type II (CRPS type II) in the hand after the transradial coronary intervention, which may alert medical personnel that the technique may cause serious regional pain with disability. A 61-year-old woman underwent coronary intervention via the right radial artery for the treatment of unstable angina. After the operation she complained of severe pain in the right hand, consistently felt along the median nerve distribution. The nerve conduction study suggested carpal tunnel syndrome. We made a diagnosis of CRPS type II, and the patient received stellate ganglion blockade, cervical epidural blockade, and administration of amitriptyline and loxoprofen. The symptoms gradually improved and her activities of daily living markedly improved. The median nerve appeared to be damaged by local compression and potential ischemia. Careful attention should be paid to avoid CRPS type II, associated with excess compression.
Sasano
Nobuko
N
Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya 467-8622, Japan.
Tsuda
Takako
T
Sasano
Hiroshi
H
Ito
Shoji
S
Sobue
Kazuya
K
Katsuya
Hirotada
H
D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000379:methods; D002422:Causalgia / Q000209:etiology*; D005260:Female; D006801:Humans; D008475:Median Nerve; D008875:Middle Aged