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Effective Adolescent Hand CRPS Type 1 Treatment Using Ketamine, Gabapentin, and Supraclavicular Nerve Block
Harshini Medikondu1, Alexander Davit1, Mihaela Visoiu1
1Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA.
None:
A 15-year-old female developed refractory Complex Regional Pain Syndrome (CRPS) Type I of the left hand following metacarpal fixation. Conservative therapy and hand rehabilitation failed, resulting in persistent allodynia and functional loss. She was admitted for multimodal analgesia combining subanesthetic ketamine infusion, gabapentin, and a tunneled supraclavicular continuous nerve catheter delivering ropivacaine. Pain decreased from 7/10 at rest to 0/10 within 48 h. Allodynia has resolved, and motor function has fully recovered. The catheter was removed nine days later without complication, and pain remission persisted. This case demonstrates a safe and effective multimodal strategy for adolescent CRPS integrating central and peripheral desensitization mechanisms.
