Journal of Pain Research (Dec 2020)
Ultrasound-Guided Thoracic Paravertebral Block as a Sympathetic Blockade for Upper Extremity Neuropathic Pain: A Prospective Pilot Study
Abstract
Jeongsoo Kim,1 Ho-Jin Lee,1,2 Young-Ju Lee,3 Chang-Soon Lee,1,2,4 Yongjae Yoo,1,2,4 Jee Youn Moon1,2,4 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Republic of Korea; 2Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; 3Department of Anesthesiology and Pain Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea; 4Integrated Cancer Management Center, Seoul National University Cancer Hospital, Seoul, Republic of KoreaCorrespondence: Jee Youn MoonDepartment of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul 03080, Republic of KoreaTel +82-2-2072-2462Fax +82-2-763-9390Email [email protected]: Ultrasound-guided thoracic paravertebral block (US-TPVB) is considered a treatment option for the management of acute pain in various pain-related conditions. We conducted a prospective pilot study to evaluate the possibility of US-TPVB as a sympathetic blockade in patients with neuropathic pain disorders in the upper extremities.Patients and Methods: A total of 12 patients underwent US-TPVB between the T2 and T3 paravertebral space with 10 mL of 1% mepivacaine. The temperature change (°C) before and after the procedure was compared between the ipsilateral and contralateral hands. We counted the proportion of patients showing a temperature increase ≥ 1.5°C and compared a change in the pain intensity before and after the procedure.Results: The median increase in the temperature change between the ipsilateral and contralateral hands was 1.54°C (interquartile range, 1.28– 2.20). There were seven patients (58.3%) who showed a temperature difference ≥ 1.5°C between both hands after the US-TPVB. Eleven patients (91.7%) reported a reduction in pain according to the score on the 11-point numerical rating scale. No serious complications relevant to the procedure were reported.Conclusion: US-TPVB could be a useful technique for sympathetic blockade in patients with upper extremity pain.Keywords: neuropathic pain, upper extremity, paravertebral block, sympathetic block, ultrasound
