Surgery on the affected upper extremity of patients with a history of complex regional pain syndrome: a retrospective study of 100 patients.
Surgery on the extremity affected with complex regional pain syndrome (CRPS) is generally avoided because of the risk that the symptoms will recur or worsen. Perioperative sympathectomy or stellate ganglion block has previously been recommended for CRPS patients requiring surgery of the affected upper extremity. We evaluated 100 patients with a history of upper extremity CRPS undergoing surgery on the affected extremity. All signs and symptoms of CRPS had resolved before surgery. After completion of the surgical procedure half of the patients (n = 50) underwent a stellate ganglion block; the other half received no intervention. The recurrence rate of CRPS was significantly lower in those patients receiving a postoperative stellate ganglion block (n = 5; 10%) compared with those receiving no intervention (n = 36; 72%). We conclude that performing a perioperative stellate ganglion block in patients with a history of CRPS can significantly reduce the recurrence rate of this disease process.
Reuben
S S
SS
Department of Anesthesiology, Baystate Medical Center, Springfield, MA 01199, USA.
Rosenthal
E A
EA
Steinberg
R B
RB
D000779:Anesthetics, Local; D001132:Arm / Q000601:surgery*; D001340:Autonomic Nerve Block / Q000379:methods; D002045:Bupivacaine; D005260:Female; D006801:Humans; D008297:Male; D012008:Recurrence; D012019:Reflex Sympathetic Dystrophy / Q000601:surgery*; D012189:Retrospective Studies; D013233:Stellate Ganglion; D013997:Time Factors
D000779:Anesthetics, Local; D002045:Bupivacaine