Successful treatment of paediatric lower limb CRPS by continuous epidural anaesthesia: a report of 2 cases

CRPS occurs in children less frequently than in adults, but in the last two decades it has become a well-established entity in children and adolescents. The symptomatology, course, responsiveness to treatment and prognosis of the paediatric disease is also different from the “adult” form. The paper presents the successful treatment of two cases of paediatric CRPS involving the lower limb, by continuous epidural anaesthesia with bupivacaine. Both patients developed the condition after minor trauma or overuse. CRPS diagnosis was based on clinical grounds. Both patients presented a history of psychological distress, due to familial problems. In one patient, the initial treatment was lumbar sympathetic block, resulting in immediate and complete recovery. After relapse of the disease at four months, the next intervention included continuous epidural infusion of bupivacaine, with an excellent and rapid response. In the 2nd case, continuous epidural infusion was used primarily with the same, excellent and fast result. The article discusses clinical peculiarities, treatment modalities and other aspects of paediatric CRPS. Poor awareness of the condition in the paediatric community is also emphasized