Key result
A continuous popliteal nerve block provided effective postoperative pain relief in a patient with sporadic erythromelalgia who was found to be a homozygous carrier of the SCN9A rs6746030 polymorphism.
Why the study?
Does a popliteal pain catheter provide effective and safe postoperative pain relief in a patient with erythromelalgia?
Case Report (n=1)
No
Does a popliteal pain catheter provide effective and safe postoperative pain relief in a patient with erythromelalgia?
A popliteal pain catheter can provide effective and safe postoperative pain relief in patients with erythromelalgia, even in the presence of an SCN9A mutation.
Suggests regional anesthesia utility in SCN9A erythromelalgia; hypothesis-generating, requires prospective trials before practice change.
A 68-year-old female with a history of sporadic type and presumably secondary erythromelalgia with chronic intractable pain presented for foot surgery. The procedure was performed with combined general anesthesia and regional anesthesia consisting of the placement of a popliteal pain catheter for postoperative pain management. Subsequent whole-genome sequencing revealed that the patient was a homozygous carrier of the common missense mutation in the SCN9A gene coding for voltage-gated sodium channel (NaV1.7) - dbSNP rs6746030 (R1150W). The occurrence of this single nucleotide polymorphism (SNP) was previously suggested not to be associated with erythromelalgia but rather thought to be part of quantitative changes in the pain threshold in different cohorts of patients. The placement of the pain catheter, although controversial in patients with erythromelalgia, provided effective postoperative pain relief without any side effects.
No takes yet. Share an insight, caveat, or question.
Janicki et al. (2019) conducted a case report in Sporadic Erythromelalgia (n=1). Continuous popliteal nerve block and whole-genome sequencing was evaluated on Postoperative pain relief and genetic variant identification. A continuous popliteal nerve block provided effective postoperative pain relief in a patient with sporadic erythromelalgia who was found to be a homozygous carrier of the SCN9A rs6746030 polymorphism.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: