{
  "abstract": "Background and Aims Complex Regional Pain Syndrome (CRPS) is a chronic pain condition with a range of sensory, autonomic, motor, and trophic changes to the extremities. Limited understanding of its mechanisms, optimal interventions, and necessary precautions in surgical settings to prevent flares and spread in patients already diagnosed with the syndrome necessitate more research. The aim of this study was to identify and characterize surgical patients with CRPS at Hospital for Special Surgery (HSS) and summarize recommended preventative perioperative pain management strategies.Methods After IRB approval, surgical patients diagnosed with CRPS who were seen preoperatively and during admission by the Perioperative Pain Service (POPS) from January 10th, 2022, to July 5th, 2024, at HSS were extracted from an institutional Electronic Health Record-based registry. Details of patients’ preoperative and in-patient pain consultation notes were evaluated. Descriptive statistics were used to summarize the findings including details of perioperative pain management plans.Results A total of 160 surgical cases were identified; most patients (78%) were female, 41% had an anxiety disorder, and 49% had a diagnosis of lower extremity CRPS ( table 1). Overall, 56.9% had surgery on the limb affected by CRPS. Acute postoperative ketamine infusions were recommended for 53.8% of patients, 92% of which received the intervention. Peripheral nerve blocks were administered to the affected limb in 73.6% of affected-limb cases. Preoperative or postoperative sympathetic blocks were recommended in 11.3% of cases.Abstract EP144 Table 1Patient and case characteristicsAbstract EP144 Table 2Perioperative pain management recommendationsAbstract EP144 Table 3Perioperative pain management practicesConclusions At HSS, surgical patients with CRPS are managed by the POPS team and typically receive recommendations for ketamine infusions, anticonvulsant medications, and patient-controlled analgesia. Future analyses will examine surgical precautions implemented such as avoidance of tourniquets, and the impact of these strategies on postoperative pain scores and incidence of flares during admission.",
  "authors": [
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA",
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA"
      ],
      "name": "Fay Rim"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Tina Chen"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "William Chan"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Justine Jorgensen"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA"
      ],
      "name": "Victoria Xu"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA",
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA"
      ],
      "name": "Semih Gungor"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA",
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA"
      ],
      "name": "Anuj Malhotra"
    },
    {
      "affiliations": [
        "Pain Prevention Research Center, Department of Anesthesiology, Critical Care and Pain Management, Hospital for Special Surgery, New York, USA",
        "Department of Anesthesiology, Weill Cornell Medicine, New York, USA"
      ],
      "name": "Alexandra Sideris"
    }
  ],
  "title": "EP144 Perioperative pain management of patients with complex regional pain syndrome undergoing orthopedic surgery: a registry study",
  "uid": "4155c6d3-70de-5e87-b2a1-d63ec917d1b4"
}