title: Incidence of regional pain syndrome after carpal tunnel release. Is there a correlation with the anesthetic technique?
abstract: OBJECTIVE
  Complex regional pain syndrome (CRPS) previously known as reflex sympathetic dystrophy refers to a set of signs and symptoms that include pain, increased sweating, and vasomotor instability. Pain is usually triggered by a noxious stimulus in a peripheral nerve, which is disproportionate to the triggering stimulus. Its development after surgery is not uncommon varying with the type of intervention. An incidence of 2.1 to 5% has been reported after carpal tunnel release (CTR). Sympathetic blockade may prevent the onset of CRPS. However, there is no study validating this technique to prevent CRPS after CTR. The objective of the present study was to define the incidence of CRPS after CTR and its relationship with four anesthetic techniques.
  
  
  METHODS
  Patients were randomly distributed to undergo one of the following techniques: general anesthesia, regional intravenous anesthesia with lidocaine, regional intravenous anesthesia with lidocaine and clonidine, or axillary plexus block. Postoperatively, they were followed-up by a nurse who was unaware of the anesthetic technique used, and follow-up was done through electronic patient records for up to 6 months after the anesthesia. During this period signs and symptoms typical of CRPS were investigated and, if positive, treatment was instituted. A descriptive evaluation using the chi-square test was performed.
  
  
  RESULTS
  Three-hundred and one patients were investigated. Twenty-five of them developed CRPS, an incidence of 8.3%. Predominance was not observed among the anesthetic techniques used. Other factors such as smoking, profession, and other concomitant diseases were also investigated, and none showed a relationship with the development of post-CTR CRPS.
  
  
  CONCLUSIONS
  Complex regional pain syndrome has an incidence of 8.3% after CTR surgery without association with the anesthetic techniques investigated.
authors: Rehabilitation Sciences, Anesthesiologist of Hospital SARAH, Brasília. veve@sarah.br
authors: Veronica Vieira
authors: VV
authors: da Costa
authors: Sandro Barbosa
authors: SB
authors: de Oliveira
authors: Maria do Carmo Barreto
authors: Mdo C
authors: Fernandes
authors: Renato Ângelo
authors: RÂ
authors: Saraiva
mesh_terms: D000758:Anesthesia / Q000009:adverse effects*; D002349:Carpal Tunnel Syndrome / Q000601:surgery; D020918:Complex Regional Pain Syndromes / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*