Comparación de dos accesos venosos para el implante de dispositivos de estimulación cardiaca

摘要

We present the case of a young male presenting with intense burning pain in the left leg after a hip replacement surgery. The patient`s leg was hypotrophic with distal cyanosis, skin trophic changes and low amplitude pulses. Ultrasound doppler study showed normal arterial flow in both legs. He was diagnosed with a Complex Regional Pain Syndrome. Nonsteoidal anti-inflammatory drugs and neuromodulator drugs were started complemented by physical therapy with partial symptomatic relief. A lumbar sympathectomy was performed reaching complete symptoms remission.6 Complex Regional Pain Syndrome is characterized by intense and disproportionate local pain associated with vasomotor and trophic phenomena. An excessive sympathetic response is part of it`s physiopathology mechanisms. Diagnostic criteria include the presence of neuropathic pain, vasomotor and trophic changes and no other disease explaining the symptoms. A multidisciplinary management is needed. Physical, psychological and pharmacological therapies are the first line of treatment. Sympathectomy has shown excellent results with long lasting pain relief.