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Continuous Thoracic Sympathetic Ganglion Block in Complex Regional Pain Syndrome Patients with Spinal Cord Stimulation Implantation


Affiliations
1 Department of Anesthesiology and Pain Medicine, Daejeon St.Mary’s Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 301-723, Korea, Republic of
 

The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS). However, single sympathetic block often provides only short-term effect.Moreover, frequent procedures for sympathetic block may increase the risk of complications. The use of epidural route may be limited by concern of infection in case of previous implantation of the spinal cord stimulation (SCS). In contrast, a continuous sympathetic block can be administered without such concerns. The continuous thoracic sympathetic block (TSGB) has been used to treat the ischemic disease and other neuropathic conditions such as postherpetic neuralgia.We administered continuous thoracic sympathetic block using catheter in CRPS patients who underwent SCS implantations and achieved desirable outcomes. We believe a continuous sympathetic block is a considerable option before performing neurolysis or radiofrequency rhizotomy and even after SCS implantation.
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  • Continuous Thoracic Sympathetic Ganglion Block in Complex Regional Pain Syndrome Patients with Spinal Cord Stimulation Implantation

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Authors

EungDon Kim
Department of Anesthesiology and Pain Medicine, Daejeon St.Mary’s Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 301-723, Korea, Republic of
MiSun Roh
Department of Anesthesiology and Pain Medicine, Daejeon St.Mary’s Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 301-723, Korea, Republic of
SooHyang Kim
Department of Anesthesiology and Pain Medicine, Daejeon St.Mary’s Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 301-723, Korea, Republic of
DaeHyun Jo
Department of Anesthesiology and Pain Medicine, Daejeon St.Mary’s Hospital, The Catholic University of Korea, Daeheung-ro 64, Jung-gu, Daejeon 301-723, Korea, Republic of

Abstract


The sympathetic block is widely used for treating neuropathic pain such as complex regional pain syndrome (CRPS). However, single sympathetic block often provides only short-term effect.Moreover, frequent procedures for sympathetic block may increase the risk of complications. The use of epidural route may be limited by concern of infection in case of previous implantation of the spinal cord stimulation (SCS). In contrast, a continuous sympathetic block can be administered without such concerns. The continuous thoracic sympathetic block (TSGB) has been used to treat the ischemic disease and other neuropathic conditions such as postherpetic neuralgia.We administered continuous thoracic sympathetic block using catheter in CRPS patients who underwent SCS implantations and achieved desirable outcomes. We believe a continuous sympathetic block is a considerable option before performing neurolysis or radiofrequency rhizotomy and even after SCS implantation.