Spinal cord stimulation for a woman with complex regional pain syndrome who wished to get pregnant

被引:0
作者
Shoji Ito
Takeshi Sugiura
Takafumi Azami
Hiroshi Sasano
Kazuya Sobue
机构
[1] Nagoya City University Graduate School of Medical Sciences,Department of Anesthesiology and Medical Crisis Management
来源
Journal of Anesthesia | 2013年 / 27卷
关键词
Spinal cord stimulation; Complex regional pain syndrome; Pregnancy; Delivery;
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中图分类号
学科分类号
摘要
A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th10–11 in the epidural space, accessed via the L2–3 interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day. After she had experienced several chemical abortions, finally she got pregnant via artificial insemination. She had an uneventful delivery of a healthy baby by cesarean resection under spinal anesthesia. In a patient with CRPS who has an implanted SCS system and wishes to get pregnant, the electrode lead into the low thoracic epidural space should be accessed via the high lumbar intervertebral space in consideration of a future requirement for spinal or epidural anesthesia for cesarean section. The generator should be placed in the buttock to prevent impairment of the SCS system being caused by the enlarged abdomen during pregnancy. Although we were apprehensive of adverse effects owing to the electromagnetic field force and change of blood flow in the pelvic viscera, our patient had a successful delivery. SCS is a favorable option for patients with CRPS who wish to get pregnant.
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页码:124 / 127
页数:3
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  • [1] Perez RS(2010)Evidence based guidelines for complex regional pain syndrome type 1 BMC Neurol 10 20-33
  • [2] Zollinger PE(2011)Spinal cord stimulation is effective in management of complex regional pain syndrome I: fact or fiction Neurosurgery 69 566-578
  • [3] Dijkstra PU(2009)A web-based cross-sectional epidemiological survey of complex regional pain syndrome Reg Anesth Pain Med 34 110-115
  • [4] Thomassen-Hilgersom IL(2005)Interventional techniques in the management of chronic spinal pain: evidence-based practice guidelines Pain Phys 8 1-47
  • [5] Zuurmond WW(2010)What does the mechanism of spinal cord stimulation tell us about complex regional pain syndrome? Pain Med 11 1278-1283
  • [6] Rosenbrand KC(2002)A population-based prospective cohort study of personal exposure to magnetic fields during pregnancy and the risk of miscarriage Epidemiology 13 9-20
  • [7] Kumar K(1995)Exposure to electromagnetic fields during pregnancy with emphasis on electrically heated beds: association with birthweight and intrauterine growth retardation Epidemiology 6 263-270
  • [8] Rizvi S(1999)Spinal cord stimulation, conception, pregnancy and labor: case study in a complex regional pain syndrome patient Neuromodulation 2 41-45
  • [9] Bnurs SB(2006)Labor epidural placement in a woman with a cervical spinal cord stimulator Int J Obstet Anesth 15 246-249
  • [10] Sharma A(2009)Spinal cord stimulation in the first two trimesters of pregnancy: case report and review of the literature Neuromodulation 12 281-283