Lumbar Sympathetic Plexus Block as a Treatment for Postamputation Pain: Methodology for a Randomized Controlled Trial

McCormick, Zachary L; Hendrix, Andrew; Dayanim, David; Clay, Bryan S.; Kirsling, A.; Harden, Norman

doi:10.1093/pm/pny041

Cited by 10 publications

(7 citation statements)

References 33 publications

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“…Acupuncture also stimulates blood flow to restore nerve damage. Acupuncture was found to be an effective treatment option for diabetic and human immunodeficiency virusrelated peripheral neuropathy, especially in Bell's palsy and carpal tunnel syndrome [98][99][100]. Battlefield acupuncture (BFA) is an emerging method of easing neuropathic pain, purported to influence central nervous system pain processing through the release of β-endorphins and its effect on a somatotopic organization of the body represented in the auricle.…”

Section: Complementary and Integrative Medicine (Cim)mentioning

confidence: 99%

Managing Chronic Neuropathic Pain: Recent Advances and New Challenges

Hange

Poudel

Ozair

et al. 2022

Neurology Research International

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Aim. Neuropathic pain affects 7–10% of the population, with most of the patients receiving inadequate and incomplete treatment. Owing to the high financial burden and the poor quality of life of the patients and their caretakers, there is a dire need to address the challenges in diagnosing and treating chronic neuropathic pain. Methods. This literature review was conducted to review novel treatments and related challenges through a systematic search from sources such as PubMed, Google Scholar with the combination of MESH words such as neuropathic pain, management of neuropathic pain. Articles from non-English literature, reports without human subjects, animal studies, and abstracts/posters were excluded. However, human studies and studies published in English were included. Result. This review article discusses novel treatment modalities while acknowledging the challenges medical workers face while encountering neuropathic pain. Despite the recent advances in diagnosis and treatment modalities, several challenges still exist. Hence, there is still a need to explore the various treatment modalities, emphasizing the cause and underlying pathophysiology of neuropathic pain. Conclusion. We recommend integrated multimodal treatment with the current treatment facility, including various medical disciplines. However, a personalized approach would work the best depending on the ’patient’s medical history. Therefore, this article recommends an integrated, cause-specific, cost-effective approach to address this problem of chronic neuropathic pain.

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Section: Complementary and Integrative Medicine (Cim)mentioning

confidence: 99%

Managing Chronic Neuropathic Pain: Recent Advances and New Challenges

Hange

Poudel

Ozair

et al. 2022

Neurology Research International

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“…LSGB provides good analgesia after surgery 63 . With regard to perioperative pain management, LSGB can reduce residual limb pain and PLP during the perioperative period and help patients to recover psychologically after surgery 43 . The causes of pain after lumbar spine surgery are complex.…”

Section: Application Prospect Of Lsgb During the Perioperative Periodmentioning

confidence: 99%

“…Case reports find LSGB is safe and effective for reducing PLP. [43][44][45] Taken together, LSGB has a significant effect on NP relief (Table 1). 46,47…”

Section: Neuropathic Painmentioning

confidence: 99%

Efficacy of the lumbar sympathetic ganglion block in lower limb pain and its application prospects during the perioperative period

Zhang

Deng

Geng

2022

Ibrain

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The sympathetic nervous system is involved in the physiological pathogenesis of many different types of chronic pain. Sympathetic blocks can interrupt the reflex control system by intercepting the noxious afferent fibers accompanying autonomic nerves, resulting in changes in peripheral or central sensory processing. A lumbar sympathetic ganglion block (LSGB), as a treatment method, refers to the injection of nerve blockers into the corresponding lumbar sympathetic nerve segments, usually requiring imaging assistance (CT, X-ray, ultrasound) to guide. At present, LSGB has been widely used in the clinical treatment of lower limb pain, such as neuropathic pain, lower limb ischemic pain, and so on. Its mechanism of action may be through inhibiting sympathetic nerve activity and dilating blood vessels, thereby alleviating pain and inhibiting stress response. However, there are few reports of LSGB during the perioperative period, especially in postoperative pain and gastrointestinal function. Therefore, by studying the literature about LSGB-related studies, this article reviews the anatomy of the lumbar sympathetic nerve (LSN), with its clinical application and possible mechanism. We reviewed the analgesic effect of LSGB in patients with lower limb pain and postoperative pain and the potential application prospects in the recovery of gastrointestinal function, finally providing a reference for its clinical application.

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“…It is not yet clear what the role may be in PHN [94]. In some cases, it has been hypothesized to be involved in DNP [95] and in PANP treatment [96].…”

Section: Surgical Therapiesmentioning

confidence: 99%

“…It has been demonstrated that acupuncture can be an effective therapeutic option in reducing the pain of diabetic neuropathy and chronic low back pain; however, it is still unclear how effective it is, even though safe and generally well tolerated, in other neuropathic pain syndromes such as post-stroke and post-herpetic neuralgia [96]. Acupuncture has been shown to be safe in many studies, although its efficacy compared to drug therapy has not yet been unequivocally demonstrated [106] and in some cases has proven ineffective.…”

Section: Acupuncturementioning

confidence: 99%

Neuropathic Pain in the Elderly

et al. 2021

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Neuropathic pain due to a lesion or a disease of the somatosensory system often affects older people presenting several comorbidities. Moreover, elderly patients are often poly-medicated, hospitalized and treated in a nursing home with a growing risk of drug interaction and recurrent hospitalization. Neuropathic pain in the elderly has to be managed by a multidimensional approach that involves several medical, social and psychological professionals in order to improve the quality of life of the patients and, where present, their relatives.

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Lumbar Sympathetic Plexus Block as a Treatment for Postamputation Pain: Methodology for a Randomized Controlled Trial

Abstract: An appropriately powered randomized controlled study using this methodology may not only aid in determining the possible clinical efficacy of lumbar sympathetic block in PAP, but could also improve our understanding of underlying pathophysiologic mechanisms of PAP.

Cited by 10 publications

References 33 publications

Managing Chronic Neuropathic Pain: Recent Advances and New Challenges

Managing Chronic Neuropathic Pain: Recent Advances and New Challenges

Efficacy of the lumbar sympathetic ganglion block in lower limb pain and its application prospects during the perioperative period

Neuropathic Pain in the Elderly

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