Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of).
Dept of Anesthesiology, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Reg Anesth Pain Med. 2024 Jul 8;49(7):528-535. doi: 10.1136/rapm-2023-104624.
Thoracic sympathetic ganglion block (TSGB) is a procedure to manage sympathetically maintained upper extremity pain (sympathetically maintained pain). To date, only a few studies have evaluated the clinical effectiveness of TSGB in pain medicine. This study investigated (1) the relationship between technical success of TSGB and pain reduction in patients with chronic upper extremity pain and (2) relevant clinical factors for a positive TSGB outcome.
We retrospectively reviewed medical data in 232 patients who received TSGB from 2004 to 2020. Technical success and a positive outcome of TSGB were defined as a temperature increase of ≥1.5°C at 20 min and a pain reduction with ≥2 points on the 11-point Numerical Rating Scale at 2 weeks post-TSGB, respectively. Correlations were assessed using correlation coefficients (R), and multivariable regression model was used to identify factors relevant to TSGB outcomes.
207 patients were ultimately analyzed; among them, 115 (55.5%) patients positively responded to TSGB, and 139 (67.1%) achieved technical success after TSGB. No significant relationship existed between the pain reduction and the temperature increase after TSGB (=0.013, p=0.855). Comorbid diabetes (OR 4.200) and adjuvant intake (OR 3.451) were positively associated, and psychiatric comorbidity (OR 0.327) and pain duration (OR 0.973) were negatively associated with TSGB outcome.
We found no significant association between the temperature increase and pain reduction after TSGB. Further studies are warranted to identify significant factors associated with TSGB outcomes in patients with complex regional pain syndrome and neuropathic pain diseases.
胸交感神经节阻滞（TSGB）是一种用于治疗交感神经维持的上肢疼痛（交感神经维持性疼痛）的方法。迄今为止，只有少数研究评估了 TSBG 在疼痛医学中的临床效果。本研究调查了（1）TSGB 技术成功率与慢性上肢疼痛患者疼痛减轻之间的关系，以及（2）TSGB 结果的相关临床因素。
我们回顾性分析了 2004 年至 2020 年期间接受 TSBG 的 232 例患者的医疗数据。TSGB 的技术成功和阳性结果分别定义为 20 分钟时温度升高≥1.5°C，以及 2 周后 TSBG 时数字评分量表上的疼痛减轻≥2 分。使用相关系数（R）评估相关性，使用多变量回归模型确定与 TSBG 结果相关的因素。
最终分析了 207 例患者；其中，115 例（55.5%）患者对 TSBG 有阳性反应，139 例（67.1%）患者在 TSBG 后达到技术成功。TSGB 后疼痛减轻与温度升高之间没有显著关系（=0.013，p=0.855）。合并糖尿病（OR 4.200）和辅助摄入（OR 3.451）呈正相关，而精神合并症（OR 0.327）和疼痛持续时间（OR 0.973）与 TSBG 结果呈负相关。
我们发现 TSBG 后温度升高与疼痛减轻之间没有显著关系。需要进一步的研究来确定与复杂区域疼痛综合征和神经病理性疼痛疾病患者 TSBG 结果相关的显著因素。
