Parche de lidocaína al 5% para el tratamiento del SDRC de extremidad superior por bloqueo transcutáneo del plexo braquial: Caso Clínico

摘要

The complex regional pain syndrome (SDRC) it is characterized by pain, functional impotence, and tróphics alterations. The cause is a primary injury or a dysfunction of the Nervous System. SDRC-I that replaces term SRD and the SDRC-II instead of the term causalgia. Clinical case: A man of 37 years of age, that after being put under a shoulder arthroscopy began to display pain in the shoulder and important functional limitation, as well as vasomotor changes of the same extremity, reason why was diagnosed of SDRC. The patient followed several analgesic treatment by oral route, was put under numerous, sympathetic blockades and physiotherapy treatment. During these months the clinical evolution was poor, reappearing the pain in all the occasions and without displaying improvement of mobility. It was decided to initiate treatment with lidocaine patches, with this treatment the patient was able to control the pain and restaure a complete mobilization of the shoulder. Lidocaine patch is a topic analgesic developed for the treatment of neuropathic pain. It is approved in the U.S.A. for the treatment of the postherpetic neuralgia. Nevertheless, its use in other forms of neuropathic pain is being proven, like the neuropathic diabetes, chronic back pain and the miofascial pain. The SDRC is associate with an abnormal activity of the nervous system, reason why the blockade likeable by means of the anaesthetic premises widely is used. This case is similar to which we described by others authors, in patints refractary to conventional treatment and the lidocaine patch solely obtained an important control of pain and improvement the functionality of the extremity. The low risk of interactions, makes lidocaine patch an attractive option like adjuvant analgesic therapy. Being specially beneficial in patients with many drugs and in whom they receive analgesic systemic medication.