Successful intravenous regional block with low-dose tumor necrosis factor-alpha antibody infliximab for treatment of complex regional pain syndrome 1

Anesth Analg. 2007 Oct;105(4):1148-51, table of contents. doi: 10.1213/01.ane.0000278867.24601.a0.


Cytokines, particularly tumor necrosis factor-alpha, may play an important role in the mediation of mechanical hyperalgesia and autonomic signs in complex regional pain syndrome 1. We performed an IV regional block with low-dose administration of the tumor necrosis factor-alpha antibody, infliximab, in a patient with typical clinical signs of complex regional pain syndrome 1 (moderate pain, edema, hyperhidrosis, elevated skin temperature compared with the contralateral side). A significant improvement of clinical variables was observed 24 h after infliximab treatment. Almost complete remission was reached within 8 wk, but sensory signs improved only after 6 mo. No adverse events were observed.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Complex Regional Pain Syndromes / metabolism
  • Complex Regional Pain Syndromes / physiopathology
  • Complex Regional Pain Syndromes / therapy*
  • Female
  • Humans
  • Infliximab
  • Middle Aged
  • Nerve Block*
  • Pain Threshold
  • Sensory Thresholds
  • Tumor Necrosis Factor-alpha / metabolism


  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Tumor Necrosis Factor-alpha
  • Infliximab