Objective Determine the correlation between post-sympathetic block pain temperature change, and immediate and intermediate-term pain relief. Design Retrospective analysis Setting Academic setting Subjects 79 pts with CRPS who underwent sympathetic block. Methods Pre- and post-block temperatures in the affected extremity, and pain scores immediately (based on 6-hour pain diary) post-block and at the intermediate-term 4–8-week follow-up were recorded. Post-block pain reductions of 30–49% and ≥ 50% were designated as partially sympathetically-maintained pain (SMP) and SMP. A decrease in pain score ≥ 2-points lasting ≥ 4 weeks was considered a positive intermediate-term outcome for sympathetic block. Results A weak correlation was found between immediate-term pain relief and the extent of temperature rise for the cohort (R = 0.192, P = 0.043). Greater immediate-term pain reduction was reported among patients who experienced ≥ 7.5° C temperature increase (mean 4.1, 95% CI [3.33, 4.76]) compared to those who experienced < 2° C (2.3, 95% CI [1.36, 3.31]) and ≥ 2° C x < 7.5° C (2.9, 95% CI [1.8; 3.9]; P = 0.036). The correlations between temperature increase and intermediate-term pain score reduction at 4–8 weeks (R = 0.052, P = 0.329), and between immediate and intermediate-term pain relief (R = 0.139, P = 0.119) were not statistically significant. Conclusions A weak correlation was found for those who experienced greater temperature increases post-block to experience greater immediate pain relief. Higher temperature increase cutoffs than are typically used may be necessary to determine whether a patient with CRPS has SMP.
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