Korean J Pain.  2013 Oct;26(4):401-405. 10.3344/kjp.2013.26.4.401.

Percutaneous T2 and T3 Radiofrequency Sympathectomy for Complex Regional Pain Syndrome Secondary to Brachial Plexus Injury: A Case Series

Affiliations
  • 1Department of Anesthesiology, Kuching Specialist Hospital, Sarawak, Malaysia. chenck@hotmail.my
  • 2Department of Medicine, Sarawak General Hospital, Sarawak, Malaysia.
  • 3Department of Anesthesiology, University Science Malaysia Hospital, Kelantan, Malaysia.
  • 4The Pain Specialist' Clinic, Mt. Elizabeth Medical Centre, Singapore.

Abstract

Complex regional pain syndrome secondary to brachial plexus injury is often severe, debilitating and difficult to manage. Percuteneous radiofrequency sympathectomy is a relatively new technique, which has shown promising results in various chronic pain disorders. We present four consecutive patients with complex regional pain syndrome secondary to brachial plexus injury for more than 6 months duration, who had undergone percutaneous T2 and T3 radiofrequency sympathectomy after a diagnostic block. All four patients experienced minimal pain relief with conservative treatment and stellate ganglion blockade. An acceptable 6 month pain relief was achieved in all 4 patients where pain score remained less than 50% than that of initial score and all oral analgesics were able to be tapered down. There were no complications attributed to this procedure were reported. From this case series, percutaneous T2 and T3 radiofrequency sympathectomy might play a significant role in multi-modal approach of CRPS management.

Keyword

brachial plexus neuropathies; CRPS; radiofrequency; sympathectomy; thoracic

MeSH Terms

Analgesics
Brachial Plexus
Brachial Plexus Neuropathies
Chronic Pain
Humans
Stellate Ganglion
Sympathectomy
Analgesics

Figure

  • Fig. 1 Anteroposterior and lateral view of final needle position at T2 vertebral body.


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