Evidence Analysis of Sympathetic Blocks for Visceral Pain

Nagpal, Ameet S.; Vydra, Darrell; Correa, Jesus A.; Zoch, Isaac A.; Boies, Brian

doi:10.1007/s40141-019-00226-7

Cited by 2 publications

(2 citation statements)

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“…Thoracic sympathetic ganglion block alleviating allodynia and hyperalgesia intensity suggests that the sympathetic nervous system can be a therapeutic target for postmastectomy pain syndrome [ 11 , 15 ]. The sympathetic nervous system depresses acute pain perception via descending inhibition of nociception [ 13 , 27 ]. Paradoxically, chronic activation of the sympathetic nervous system may augment pain and lead to sympathetically maintained neuropathic pain [ 15 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Local inflammation may activate the surrounding glia and induce sprouting of sympathetic nerve fibers, which may provide excitatory inputs to dorsal root ganglion neurons and further provoke the inflammation process [ 29 ]. These interactions may play an important role in the initiation of chronic pain, allodynia, and hyperalgesia [ 27 – 29 ]. CBCT-assisted ethanol neurolytic thoracic sympathetic ganglion block may be a useful alternative for intractable postmastectomy pain syndrome as it alleviates sympathetically maintained neuropathic pain.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Successful neurolytic thoracic sympathetic ganglion block using C-arm fluoroscopic cone-beam computed tomography in patients with postmastectomy pain syndrome: a report of 3 cases

Hagihara,

Abe,

Godai

et al. 2023

JA Clin Rep

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Background Postmastectomy pain syndrome involves persistent neuropathic and sympathetically maintained neuropathic pain that can be improved using a thoracic sympathetic ganglion block. However, conventional fluoroscopic procedures pose technical difficulties and are associated with potential severe complications. We report the use of C-arm fluoroscopic cone-beam computed tomography to enhance procedural success and treatment safety. Case presentation Three women diagnosed with postmastectomy pain syndrome and experiencing persistent pain underwent C-arm fluoroscopic cone-beam computed tomography-assisted ethanol neurolytic thoracic sympathetic ganglion block. Pain severity decreased substantially after the procedure. The therapeutic effects were sustained for 12 months in cases 1 and 2 and for 5 months in case 3. All patients experienced a remarkable decrease in allodynia and hyperalgesia intensities. Conclusion C-arm fluoroscopic cone-beam computed tomography-assisted neurolytic thoracic sympathetic ganglion block offers a valuable alternative for managing otherwise intractable postmastectomy pain syndrome before considering more invasive techniques.

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