Complex regional pain syndrome type I: efficacy of stellate ganglion blockade

Abstract

BackgroundThis study was performed to evaluate the treatment of complex regional pain syndrome (CRPS) type I with stellate ganglion blockade.Materials and methodsWe performed three blockades at weekly intervals in 22 patients with CRPS type I in one hand. The patients were divided into two groups depending on the time between symptom onset and treatment initiation. Group 1and 2 patients had short and long symptom-onset-to-treatment intervals, respectively. Pain intensity, using a visual analog score (VAS), and range of motion (ROM) for the wrist joint were assessed before and 2 weeks after treatment and were compared using nonparametric statistical analysis.ResultsTreatment produced a statistically significant difference in wrist ROM for all patients (P < 0.001). VAS values showed an overall decrease from 8 ± 1 to 1 ± 1 following treatment, and there was a significant difference in VAS value between groups 1 and 2 (P < 0.05).ConclusionsWe concluded that stellate ganglion blockade successfully decreased VAS and increased ROM of wrist joints in patients with CRPS type I. Further, the duration between symptom onset and therapy initiation was a major factor affecting blockade success.

Effectiveness of Stellate Ganglion Block Under Fuoroscopy or Ultrasound Guidance in Upper Extremity CRPS

“…In one study performed by Yucel et al, stellate ganglion blockade under fluoroscopic guidance successfully decreased VAS and increased ROM of wrist joints in patients with CRPS [17]. These findings are comprable with the results of our study.…”

Raquianestesia total após bloqueio de gânglio estrelado em paciente com síndrome dolorosa complexa regional: relato de caso

“…Second line drugs indicated for limited situations are steroids and other anticonvulsants and antidepressants. Sympathetic block is one of the commonest options 7 and more promising results are obtained the earlier the blockade is induced 8 . For upper limbs CRPS (UULL), stellate ganglion blockade is indicated 9 and is aimed at decreasing pain and functionally improving the affected limb.…”

Modalities for Complex Regional Pain Syndrome

“…Three stellate ganglion blocks at weekly intervals have been shown to improve pain and range of motion in patients with CRPS of the upper extremity. 25 Nonetheless, a Cochrane Review determined that existing data regarding stellate blocks for CRPS were of low quality and no conclusions could be drawn. 26 Formal surgical sympathectomy, an extension of the same treatment principle, has shown benefit in select cases, but response to stellate blockade did not predict outcome after sympathectomy.…”