Reflex Sympathetic Dystrophy (Complex Regional Pain Syndrome)

Incidence of 5.5:100,000 person years at risk (50,000 new cases per y in USA).

Prevalence of 21:100,000 person years at risk.

Female:male ratio is 2–4:1.

Mean peak age is 37–50 y.

Incidence of CRPS I is 1–2% after fractures, 12% after brain lesions; and 5% after MI.

Incidence of CRPS II is 1–5% after injury to a peripheral nerve.

Increased pain flare postop if procedure is on affected extremity

Increased tolerance and/or opioid requirements if managed with chronic opioids

Increased incidence of comorbid anxiety and depression

Exacerbation or recurrence of CRPS with manipulation of affected extremity.

Careful positioning of affected extremity.

Interactions and/or end-organ effects of chronic pain medications.

IV access and/or tourniquet placement on affected extremity may be intolerable because of pain.