ABSTRACT
Sympathetic ganglion block (SGB) or intravenous regional block (IVRB) has been recommended for pain management in patients with complex regional pain syndrome type I (CRPS-I). Forty-five patients were initially selected but only 43 were accepted for the study. The present study evaluated the efficacy of IVRB produced by combining 70 mg lidocaine with 30 µg clonidine (14 patients, 1 male/13 females, age range: 27-50 years) versus SGB produced by the injection of 70 mg lidocaine alone (14 patients, 1 male/13 females, age range: 27-54 years) or combined with 30 µg clonidine (15 patients, 1 male/14 females, age range: 25-50 years) into the stellate ganglion for pain management in patients with upper extremity CRPS-I. Each procedure was repeated five times at 7-day intervals, and pain intensity and duration were measured using a visual analog scale immediately before each procedure. A progressive and significant reduction in pain scores and a significant increase in the duration of analgesia were observed in all groups following the first three blocks, but no further improvement was obtained following the last two blocks. Drowsiness, the most frequent side effect, and dry mouth occurred only in patients submitted to SGB with lidocaine combined with clonidine. The three methods were similar regarding changes in pain intensity and duration of analgesia. However, IVRB seems to be preferable to SGB due to its easier execution and lower risk of undesirable effects.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anesthesia, Intravenous/methods , Anesthetics, Local/administration & dosage , Autonomic Nerve Block/methods , Clonidine/administration & dosage , Lidocaine/administration & dosage , Reflex Sympathetic Dystrophy/drug therapy , Anesthetics, Local/adverse effects , Clonidine/adverse effects , Ganglia, Sympathetic , Lidocaine/adverse effects , Pain Measurement , Time Factors , Treatment OutcomeABSTRACT
The present paper describes a simple and inexpensive device for assessing responses of rats to calibrated noxious pinching of the dorsal skin. The method has advantages over the classic pinch test because it permits assesment of slight variations in the nociceptive threshold with little risk of skin damage, and a more precise evaluation of changes in the time course of antinociceptive procedures. The magnitude and time course of analgesia induced by morphine are evaluated using this method and the tail-flick test