上顎臼歯部に発症したCRPS type 1様の神経障害性疼痛の1症例

抄録

  We herein report the case of a 74-year-old woman who experienced severe neuropathic pain following the placement of five dental implants and the subsequent removal of one implant. Her condition was successfully treated with repeated stellate ganglion blocks (SGB) ; the intravenous infusion of adenosine 5-triphosphate (ATP), magnesium (Mg), and lidocaine ; and the oral administration of amitriptyline and tramadol hydrochloride.

  The five dental implants had been placed in the upper jaw approximately two years previously, and the patient had been suffering severe pain in the right upper molar area since that time. One of the dental implants was removed one year after the implant surgery, but the removal resulted in the aggravation of the pain, rather than relief. The patient described the continuous pain as “very cold,” “numbness,” and “thirstiness.” She was unable to eat, and apparent mechanical allodynia and dysesthesia were noted.

  The patient received a series of SGB injections and the intravenous infusion of ATP, Mg, and lidocaine. In addition, amitriptyline (10 mg/day) and tramadol hydrochloride (75 mg/day) were orally administered. The treatments were fully effective for pain relief. The patient was diagnosed as having sympathetically maintained pain and peripheral and central neuropathic pain associated with complex regional pain syndrome type 1 following dental implant surgery.