Stellate Radiofrequency Neurolysis for upper limb CRPS

Severe pains in various locations in arms can respond to burning the stellate ganglion in the neck.  67.6% of radiofrequency destruction  cases obtained  >50 % pain inprovement for over 2 years while those with just anesthetic block got 21.2% for 2 year results.  Anaesthetic block lasted average or 40.5 days only.

 Eur Radiol. 2013 May;23(5):1316-22.
CT-guided stellate ganglion blockade vs. radiofrequency neurolysis in the management of refractory type I complex regional pain syndrome of the upper limb.
Kastler A et al
http://www.ncbi.nlm.nih.gov/pubmed/23138389

  • Causes:

causes upper limb crps

 

  • Most beautiful picture of stellate ganglion:

stellatepic

  stellate lies in front of C7 transverse process and insertion first rib. Was injected with CT guidance.

  • Side effects  – 3 cases could not be done; several horner’s syndrome lasting few weeks; one hematoma bruise.
  • Results: efficacy had an OR of 7.66  –  “>50 % pain reduction lasting for at least 2 years was obtained in 67.6 % of treated patients in the RFN group as opposed to 21.2 % in the blockade group”

Conclusion – Use of chronic opioids has become more scorned upon but getting the resources to have this done regionally has not been addressed. This is another procedure not availvable here as far as I know.

 

 

 

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