A study of the efficacy of stellate ganglion blocks in complex regional pain syndromes of the upper body

Datta, Rashmi; Agrawal, Jyotsna; Sharma, Amit Kumar; Rathore, Vikram Singh; Datta, Shivesh

doi:10.4103/joacp.joacp_326_16

Cited by 26 publications

(16 citation statements)

References 28 publications

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“…In a cohort of 287 CRPS patients receiving SGB, more than half of the patients were moderately satisfied with the treatment outcome. However, to maintain the treatment effect, more than half of the patients also received more than one SGB treatment 40 . Therefore, the duration of the effect of SGB is usually temporary.…”

Section: Sgi Indications and Effectsmentioning

confidence: 99%

Stellate ganglion intervention for chronic pain: A review

Luo

Wen

Tan

et al. 2022

Ibrain

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Stellate ganglion (SG) intervention is currently widely being studied in many kinds of chronic pain. As one of the convenient ways to treat the sympathetic nervous system, the indications for stellate ganglion intervention (SGI) include complex regional pain syndrome, postherpetic neuralgia, cancer pain of different origins, orofacial pain, and so forth. SGI refers to the reversible or irreversible blocking of the cervical sympathetic trunk, cervical sympathetic ganglion, and their innervation range through noninvasive or minimally invasive treatment. Current treatment options include stellate ganglion block (SGB), SG pulsed radiofrequency, continuous radiofrequency treatment, and noninvasive SGB. In particular, SGB continues to be one of the most studied methods in chronic pain management. However, a single SGB usually provides only short-term effects; repeated SGB may result in complications such as hoarseness, light-headedness, and vessel or nerve injury. Meanwhile, the mechanism of SGI is still unclear. This review discusses the research progress of SGI methods, effectiveness, complications, and possible mechanisms in the management of chronic pain.chronic pain, pulse radiofrequency, stellate ganglion, stellate ganglion block | INTRODUCTIONChronic pain is defined as pain that persists or recurs for more than 3 months, usually accompanied by negative emotions including anxiety and/or depression. 1 Chronic pain severely affects not only physical and mental health but also places a huge economic burden on the family and society. The incidence of chronic pain is reported to be over 30% in China. 2 Current conventional methods for the treatment of chronic pain include drug therapy, minimally invasive therapy, psychotherapy, and physical therapy. 3 However, research has found that sympathetic nerves are involved in the maintenance of many kinds of chronic pain. 4 Therefore, inhibition of sympathetic hyperexcitability may improve the therapeutic effect, which may be related to the involvement of sympathetic nerves in regulating glial inflammation. 5 Among them, intervention of stellate ganglion (SG) is effective for pain in the head, face, neck, upper limbs, or upper chest. In this review, we summarize the clinical evidence available for the effectiveness of stellate ganglion intervention (SGI), and demonstrate clinical applications of SGI.

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Section: Sgi Indications and Effectsmentioning

confidence: 99%

Stellate ganglion intervention for chronic pain: A review

Luo

Wen

Tan

et al. 2022

Ibrain

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“…While previous studies used serial blocks with only local anesthetics, we used a single injection of local anesthetic and nonparticulate steroid, intending to prolong the block with the steroid. 14,15 Nonparticulate steroids were chosen mainly for safety to prevent the possibility of microemboli as the block area is highly vascular.…”

Section: Discussionmentioning

confidence: 99%

Stellate Ganglion Blocks for Refractory Central Poststroke Pain: A Case Series

Purohit¹,

Kumar²,

Sharma³

et al. 2023

A&A Practice

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Central poststroke pain (CPSP) is a neuropathic pain secondary to cerebrovascular accidents. This is characterized by pain and other sensory abnormalities, which correspond with the area of the injured brain. Despite advancements in therapeutic options, this clinical entity is still challenging to treat. We present 5 patients with CPSP, who were refractory to pharmacotherapy and were successfully managed with stellate ganglion blocks. A significant decrease in pain scores and improvement in functional disabilities were noted in all patients following the intervention.

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“…Pain, whether nociceptive (injurious inflammation and/or tissue damage), neuropathic (nerve damage and/or neurological disease), or nociplastic (central sensitization), is modulated by autonomous nerve fibres. Although the mechanisms of pain often overlap in between central and peripheral pathways and thus complicate the clinical presentation of various chronic polysymptomatic conditions (e.g., complex regional pain syndrome, fibromyalgia, irritable bowel syndrome), known anatomical features remain simple: parasympathetic nerves predominantly carry innocuous input whereas nociceptive information travels within afferent fibres of sympathetic nerves (Datta et al, 2017;Fitzcharles et al, 2021).…”

Section: Introductionmentioning

confidence: 99%