What is the role of selective sympathetic ganglion nerve blocks in the treatment of complex regional pain syndrome (CRPS)?

Updated: Jun 20, 2018
  • Author: Gaurav Gupta, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

Selective sympathetic ganglion nerve blocks, by their nature, present a variety of difficulties to researchers developing preferred methodological practices. First, these procedures' actual success rate in blocking sympathetic activity is unknown. [106] In addition, no placebo-controlled trials have been published. Most importantly, the mechanism of pain relief is also unknown. Some postulate that the benefit is derived from local anesthetic activity on peripheral somatic nerve fibers, not sympathetic fibers themselves, due to local anesthetic systemic actions or local spillage and spread of the injectate. [106, 107, 108, 109] Some patients who have reported transient pain relief with sympathetic blocks have also reported such results after an IV infusion of lidocaine. [1]


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