肉毒杆菌毒素交感神经阻滞治疗复杂性区域疼痛综合征。
Sympathetic block with botulinum toxin to treat complex regional pain syndrome.
作者信息
Carroll Ian, Clark J David, Mackey Sean
机构信息
Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA 94304-1573, USA.
出版信息
Ann Neurol. 2009 Mar;65(3):348-51. doi: 10.1002/ana.21601.
Abstract
Complex regional pain syndrome is a refractory pain condition with few tested therapies. We hypothesized that botulinum toxin A (BTA) would prolong analgesia after sympathetic blocks in patients with complex regional pain syndrome. We compared the duration of standard lumbar sympathetic block (LSB) with bupivacaine to LSB with bupivacaine and BTA in nine patients with refractory complex regional pain syndrome. Median time to analgesic failure was 71 (95% confidence interval, 12-253) days after LSB with BTA compared with fewer than 10 days (95% confidence interval, 0-12) after standard LSB (log-rank, p < 0.02). BTA profoundly prolonged the analgesia from sympathetic block in this preliminary study.
摘要
复杂性区域疼痛综合征是一种难治性疼痛疾病，可供测试的治疗方法很少。我们推测，肉毒杆菌毒素A（BTA）可延长复杂性区域疼痛综合征患者交感神经阻滞后的镇痛时间。我们比较了9例难治性复杂性区域疼痛综合征患者使用布比卡因进行标准腰交感神经阻滞（LSB）与使用布比卡因和BTA进行LSB后的镇痛持续时间。与标准LSB后少于10天（95%置信区间，0 - 12）相比，使用BTA进行LSB后镇痛失效的中位时间为71天（95%置信区间，12 - 253）（对数秩检验，p < 0.02）。在这项初步研究中，BTA显著延长了交感神经阻滞的镇痛时间。
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