Treatment of severe pain in a patient with complex regional pain syndrome undergoing dental treatment under general anesthesia: A case report
이승현, 박상훈, 하성호, 유승화, 감명환, 김현정, 서광석,
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이승현 ( Rhee Seung-Hyun ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
박상훈 ( Park Sang-Hun ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
하성호 ( Ha Sung-Ho ) - Seoul National University Dental Hospital Department of Oral and Maxillofacial Surgery
유승화 ( Ryoo Seung-Hwa ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
감명환 ( Karm Myong-Hwan ) - Seoul National University Dental Hospital Department of Dental Anesthesiology
김현정 ( Kim Hyun-Jeong ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
서광석 ( Seo Kwang-Suk ) - Seoul National University School of Dentistry Department of Dental Anesthesiology
Abstract
Complex regional pain syndrome (CRPS) is rare, characterized by pain from diverse causes, and presents as extreme pain even with minor irritation. General anesthesia may be required for dental treatment because the pain may not be controlled with local anesthesia. However, treatment under general anesthesia is also challenging. A 38-year-old woman with CRPS arrived for outpatient dental treatment under general anesthesia. At the fourth general anesthesia induction, she experienced severe pain resulting from her right toe touching the dental chair. Anesthesia was induced to calm her and continue the treatment. After 55 minutes of general anesthesia, the patient still complained of extreme toe pain. Subsequently, two administrations for intravenous sedation were performed, and discharge was possible in the recovery room approximately 5 h after the pain onset. The pain was not located at the dental treatment site. Although the major factor causing pain relief was unknown, ketamine may have played a role.
키워드
Complex Regional Pain Syndromes; Dental Care; Pain Management
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