Hospital do Câncer de Barretos, SP, Brasil.
Braz J Med Biol Res. 2010 Dec;43(12):1239-44. doi: 10.1590/s0100-879x2010007500123. Epub 2010 Nov 12.
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.
交感神经节阻滞(SGB)或静脉内区域阻滞(IVRB)已被推荐用于治疗 I 型复杂性区域疼痛综合征(CRPS-I)患者的疼痛管理。最初选择了 45 名患者,但只有 43 名患者接受了研究。本研究评估了将 70mg 利多卡因与 30μg 可乐定联合使用进行 IVRB(14 名患者,1 名男性/13 名女性,年龄范围:27-50 岁)与单独注射 70mg 利多卡因(14 名患者,1 名男性/13 名女性,年龄范围:27-54 岁)或联合 30μg 可乐定(15 名患者,1 名男性/14 名女性,年龄范围:25-50 岁)进行 SGB 治疗上肢 CRPS-I 患者疼痛管理的疗效。每个程序在 7 天间隔重复五次,并在每次程序之前使用视觉模拟量表测量疼痛强度和持续时间。所有组在前三轮后观察到疼痛评分的逐渐显著降低和镇痛持续时间的显著增加,但在后两轮后没有进一步改善。嗜睡是最常见的副作用,口干仅发生在接受利多卡因联合可乐定的 SGB 的患者中。三种方法在疼痛强度和镇痛持续时间的变化方面相似。然而,由于 IVRB 执行更容易且不良影响风险较低,因此似乎优于 SGB。