Anesthesia and Pain Medicine  2016;11(3):295-298

doi:10.17085/apm.2016.11.3.295

Ultrasound-guided placement of a permanent peripheral nerve stimulator in a patient with complex regional pain syndrome: A case report.

Woosuk CHUNG 1 ; Yohan KIM ; Jiyong LEE ; Sunyul LEE ; Yoonhee KIM ; Yongsup SHIN ; Wonhyung LEE ; Youngkwon KO

Affiliations

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Keywords

Complex regional pain syndromes; Implantable neurostimulator; Neuropathic pain; Pain management; Sciatic nerve; Ultrasonography

Country

Republic of Korea

Language

English

Abstract

A 56-year-old man complained of continuous pain in the right foot that began 6 months after undergoing surgery on the right calcaneus bone. The patient was diagnosed with complex regional pain syndrome (CRPS) type I and was treated with medication, lumbar sympathetic ganglion blocks, epidural nerve blocks, and spinal cord stimulation. However, all treatments were halted because they were ineffective or complications developed. Peripheral nerve stimulation (PNS) was planned after confirming the analgesic effects of a sciatic nerve block, and the patient received PNS via minimally invasive ultrasound-guided electrode placement. PNS reduced the pain intensity and the incidence of paroxysmal pain. Other than discomfort at the battery insertion site (resolved with re-implantation), the patient developed no complications. These results suggest that ultrasound-guided minimally invasive PNS is a safe and effective treatment for patients with CRPS in the lower extremities.