CT-guided stellate ganglion blockade vs. radiofrequency neurolysis in the management of refractory type I complex regional pain syndrome of the upper limb

Kastler, Adrian; Aubry, S.; Sailley, N.; Michalakis, D.; Siliman, Gaye; Gory, Guillaume; Lajoie, Jean-Louis; Kastler, B.

doi:10.1007/s00330-012-2704-y

Cited by 40 publications

(27 citation statements)

References 23 publications

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“…reported that a stellate ganglion block with 10 ml bupivacaine 0.25% at C6–C7 using fluoroscopy resulted in transient side‐effects in 84% of patients including 76% with dysphagia, but with no serious complications . A recent study using computed tomography‐guided stellate ganglion block at the C7 and T1 vertebral levels found no complications in the block group .…”

Section: Discussionmentioning

confidence: 90%

Analgesic efficacy of pre‐operative stellate ganglion block on postoperative pain relief: a randomised controlled trial

et al. 2014

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We undertook a randomised, double-blind, placebo-controlled study to compare the analgesic efficacy of pre-operative stellate ganglion block on postoperative pain relief after upper limb orthopaedic surgery. Patients were administered a 3-ml injection during ultrasound-guided stellate ganglion block; 15 patients received lidocaine 2% and 15 patients received 0.9% saline. Following the block, all patients received standardised general anaesthesia. Postoperative analgesia included regular intravenous diclofenac, paracetamol and patient-controlled analgesia with tramadol for 24 h. Patients were observed at 0, 2, 4, 6, 8, 12 and 24 h after surgery for tramadol consumption, cardiovascular variables and visual analogue scale pain scores at rest and on movement. The mean (SD) hourly tramadol consumption was significantly reduced in the lidocaine group compared with the saline group at 4 h (8.0 (10.1) mg vs 28.0 (12.6) mg, respectively; p = 0.001), 6 h (5.3 (10.8) mg vs 17.3 (12.7) mg, respectively; p = 0.013) and 8 h (5.3 (11.8) mg vs 21.3 (9.1) mg, respectively; p = 0.001). The cumulative 24-h tramadol consumption was 97.3 (16.6) mg in the lidocaine group and 150.6 (26.0) mg in the saline group (p = 0.001). There were significant differences in the pain visual analogue scale at rest at two time points; at 4 h the median (IQR [range]) visual analogue scale scores were 4 (4-6 [2-8]) in the lidocaine group and 5 (4-6 [2-7]) in the saline group (p = 0.03), and at 6 h visual analogue scale scores were 3 (3-4 [3-6]) and 4 (4-6 [2-7]), respectively (p = 0.04). Pain visual analogue scale on movement was lower in the lidocaine group at all time intervals compared with the saline group, but this did not reach statistical significance. The present study has demonstrated a postoperative tramadol-sparing and analgesic effect of pre-operative stellate ganglion block in patients undergoing upper limb orthopaedic surgery under general anaesthesia.

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Section: Discussionmentioning

confidence: 90%

Analgesic efficacy of pre‐operative stellate ganglion block on postoperative pain relief: a randomised controlled trial

et al. 2014

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“…A recent study reported that physiological uptake in coeliac ganglia is a common finding on PSMA‐HBED PET/CT imaging . In addition to coeliac ganglia uptake, we have noted frequent focal uptake in the neck correlating to the anatomic location of the stellate ganglia . In this study, we assess the frequency of PSMA‐HBED uptake in coeliac and stellate ganglia in our patient population.…”

Section: Introductionmentioning

confidence: 81%

Uptake in sympathetic ganglia on ⁶⁸Ga‐PSMA‐HBED PET/CT: A potential pitfall in scan interpretation

Kanthan

Hsiao

et al. 2017

J Med Imag Rad Onc

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“…[17] CT guidance may facilitate accurate and safe needle placement. However, given the cost-effectiveness and convenience of the procedure and, above all, the advantage of the real-time monitoring of vulnerable structures, we believe that ultrasound guidance is more suitable in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided pulsed radiofrequency treatment of the cervical sympathetic chain for complex regional pain syndrome

et al. 2017

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The stellate ganglion is a common target to manage neuropathic pain in the upper extremities. However, the effect duration of a single stellate ganglion block is often temporary. To overcome the short-term effects of a single sympathetic block, pulsed radiofrequency (PRF) can be applied. The aim of the present study was to investigate the efficacy of PRF on the cervical sympathetic chain under ultrasound guidance for complex regional pain syndrome (CRPS).Twelve CRPS patients who underwent PRF on the cervical sympathetic chain were enrolled in this retrospective analysis. Under ultrasound guidance, PRF was performed for 420 seconds at 42°C on the C6- and C7-level sympathetic chain.The pain intensity decreased significantly at 1 week after the procedure. Overall, 91.7% of patients experienced at least moderate improvement. A positive correlation was observed between the extent of pain reduction at 1 week after PRF and the degree of overall benefit (r = 0.605, P = 0.037). This reduction in symptoms was maintained for a mean of 31.41 ± 26.07 days after PRF. There were no complications associated with this procedure.PRF on the cervical sympathetic chain, which can be performed easily and safely under ultrasound guidance, should be considered an option for managing CRPS of the upper extremities.

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CT-guided stellate ganglion blockade vs. radiofrequency neurolysis in the management of refractory type I complex regional pain syndrome of the upper limb

Cited by 40 publications

References 23 publications

Analgesic efficacy of pre‐operative stellate ganglion block on postoperative pain relief: a randomised controlled trial

Analgesic efficacy of pre‐operative stellate ganglion block on postoperative pain relief: a randomised controlled trial

Uptake in sympathetic ganglia on ⁶⁸Ga‐PSMA‐HBED PET/CT: A potential pitfall in scan interpretation

Ultrasound-guided pulsed radiofrequency treatment of the cervical sympathetic chain for complex regional pain syndrome

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CT-guided stellate ganglion blockade vs. radiofrequency neurolysis in the management of refractory type I complex regional pain syndrome of the upper limb

Cited by 40 publications

References 23 publications

Analgesic efficacy of pre‐operative stellate ganglion block on postoperative pain relief: a randomised controlled trial

Analgesic efficacy of pre‐operative stellate ganglion block on postoperative pain relief: a randomised controlled trial

Uptake in sympathetic ganglia on 68Ga‐PSMA‐HBED PET/CT: A potential pitfall in scan interpretation

Ultrasound-guided pulsed radiofrequency treatment of the cervical sympathetic chain for complex regional pain syndrome

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Uptake in sympathetic ganglia on ⁶⁸Ga‐PSMA‐HBED PET/CT: A potential pitfall in scan interpretation