Effective Adolescent Hand CRPS Type 1 Treatment Using Ketamine, Gabapentin, and Supraclavicular Nerve Block Catheter—A Case Report
A 15-year-old female developed refractory Complex Regional Pain Syndrome (CRPS) Type I of the left hand following metacarpal fixation. Conservative therapy and hand rehabilitation failed, resulting in persistent allodynia and functional loss. She was admitted for multimodal analgesia combining subanesthetic ketamine infusion, gabapentin, and a tunneled supraclavicular continuous nerve catheter delivering ropivacaine. Pain decreased from 7/10 at rest to 0/10 within 48 h. Allodynia has resolved, and motor function has fully recovered. The catheter was removed nine days later without complication, and pain remission persisted. This case demonstrates a safe and effective multimodal strategy for adolescent CRPS integrating central and peripheral desensitization mechanisms.
Authors
- Alexander J. Davit (ORCID: https://orcid.org/0000-0002-5036-5310)
- Mihaela Visoiu (ORCID: https://orcid.org/0000-0003-0933-4536)
- Harshini Medikondu (ORCID: https://orcid.org/0009-0000-5244-6731)
Institutions
- University of Pittsburgh (US)
- Children's Hospital of Pittsburgh (US)
Publication Details
- Journal
- Children
- Published
- 2025-12-07
- DOI
- https://doi.org/10.3390/children12121659
- Primary Topic
- Pain Management and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00