Phantom pain with probable reflex sympathetic dystrophy: efficacy of fentanyl infiltration of the stellate ganglion.
OBJECTIVE
The stellate ganglion can alleviate phantom pain of the upper extremity, possibly because of the presence in it of enkephalin receptors, as has been suggested by experimental and clinical reports. A case is reported in which fentanyl, instead of local anesthetic, was used for stellate ganglion block.


METHODS
A 49-year-old man, with a left below-elbow amputation, presented with probable symptoms of reflex sympathetic dystrophy, pain and temperature changes at the stump, and phantom hand symptoms the English-language literature revealed no reports of the use of fentanyl infiltration of the stellate ganglion was performed for management of this condition.


RESULTS
Significant alleviation of pain and sensation of warmth at the stump and in the phantom hand was achieved.


CONCLUSIONS
Fentanyl infiltration of the stellate ganglion proved to be successful in the management of the pain and temperature sensation changes in the stump and phantom upper extremity.
Wassef
M R
MR
Department of Anesthesiology, Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, New York, USA.
D000701:Analgesics, Opioid / Q000008:administration & dosage; D001340:Autonomic Nerve Block; D005283:Fentanyl / Q000008:administration & dosage; D006225:Hand / Q000502:physiology; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D010591:Phantom Limb / Q000188:drug therapy*; D012019:Reflex Sympathetic Dystrophy / Q000188:drug therapy*; D013233:Stellate Ganglion
D000701:Analgesics, Opioid; D005283:Fentanyl