Stellate ganglion block for the treatment of complex regional pain syndrome type I in the upper limbs

Abstract

Introduction : Regional pain syndrome type 1 of the upper extremities is given by the variety of painful conditions of regional location, after a lesion that presented distal predominance, of abnormal symptoms, exceeding in magnitude and length the clinical course expected for the initial incident.
Objectives : To evaluate the effectiveness of stellate ganglion sympathetic blockade in the treatment of complex regional pain syndrome type 1 of upper extremities.
Method : A descriptive study was conducted to assess the progress of treatment by stellate ganglion block in 229 patients with complex regional pain syndrome type I in upper extremities at the Saturnino Lora Hospital Pain Clinic of Santiago de Cuba between January 2004 and December 2014, who received treatment twice a week. In each session, they were administered 5 mL of bupivacaine 0.25%. Pain intensity was assessed by the verbal rating scale and, in each appointment, the pain relief degree scale, as well as that of side effects were assessed.
Results : Age group 40-49 years predominated, 72.48% of patients belonged to the female sex. 58.3% of the total arrived to the office with total pain relief. Minimal side effects were found that did not require any treatment or prevented to continue it. There was a satisfactory therapeutic final response.
Conclusions : Stellate ganglion block proved useful in the treatment of complex regional pain syndrome type 1 of the upper limbs. Bupivacaine 0.25% (5 ml) was sufficient to produce sympathetic block of appropriate length and intensity.