tailieunhanh - Báo cáo y học: "Ketamine as an adjuvant in sympathetic blocks for management of central sensitization following peripheral nerve injury"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Ketamine as an adjuvant in sympathetic blocks for management of central sensitization following peripheral nerve injury. | Journal of Brachial Plexus and Peripheral Nerve Injury BioMed Central Open Access Case study Ketamine as an adjuvant in sympathetic blocks for management of central sensitization following peripheral nerve injury Rani A Sunder 1 Gokul Toshniwal2 and GP Dureja3 Address 1Asst Professor Dept of Anaesthesiology All India Institute of Medical Sciences New Delhi India 2Former Resident Dept of Anaesthesiology All India Institute of Medical Sciences New Delhi India and 3Ex-Professor Dept of Anaesthesiology All India Institute of Medical Sciences Currently Director - Delhi Pain Management Centre New Delhi India Email Rani A Sunder - rani_kannan2000@ Gokul Toshniwal - grtosh@ GP Dureja - dr_gpd@ Corresponding author Published 25 October 2008 Received I July 2008 Journal of Brachial Plexus and Peripheral Nerve Injury 2008 3 22 doi I749-7221-3-22 Accepted 25 October 2008 This article is available from http content 3 1 22 2008 Sunder et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Proliferation of NMDA receptors and role of glutamate in producing central sensitization and wind up phenomena in CRPS complex regional pain syndrome forms a strong basis for the use of Ketamine to block the cellular mechanisms that initiate and maintain these changes. In this case series we describe 3 patients of CRPS Type II with debilitating central sensitization heat mechano allodynia and cognitive symptoms that we termed vicarious pain . Each of these patients had dramatic relief with addition of Ketamine as an adjuvant to the sympathetic blocks after conventional therapy failed. Case Reports All 3 patients suffered gunshot wounds and developed characteristic features of CRPS Type II. .