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General Article
Anesthesia and Pain Medicine 2012;7(2):196-199.
Published online May 1, 2012.
Development of complex regional pain syndrome at independent arm associated with lateral decubitus position: A case report
Joo Eun Kang, Jae Hun Cho, Pyong Eun Park, Yea Ji Lee, Jae Hun Kim, Nam Sik Woo, Hae Kyoung Kim
Department of Anesthesiology and Pain Medicine, Konkuk University Medical Center, Seoul, Korea.
A 27-year-old man underwent excision of a mediastinal mass using video-assisted thoracoscopic surgery (VATS) performed in the right lateral position. Postoperatively, he complained of pain in the left upper arm and chest wall, limitation of the left shoulder joint, allodynia, hyperalgesia, spontaneous pain in left finger, edema, hypohidrosis, and change of skin color of the left hand. We diagnosed the patient with complex regional pain syndrome (CRPS) by using the proposed modified International Association of the Study of Pain (IASP) research diagnostic criteria, and initiated treatment through medication and interventional management. After 3 months of treatment, the pain intensity reduced to below 2 cm on the VAS. In this study, we describe a case of postoperative CRPS, which is believed to have been caused by excessive stretching of the brachial plexus. Careful positioning of patients on the operating table with proper padding will reduce injuries to the peripheral nerves.
Key Words: Brachial plexus neuropathy, Complex regional pain syndrome, Lateral decubitus position

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