engleski

Decrease of pain and alodynia in patients with complex regional pain syndromes after a series of lumbar sympathetic blocks

The dominating symptom of Complex regional pain syndroms (CRPS) is burning pain with allodynia and hyperalgesia in the afflicted extremities. The aim of our study is to prove the usefulness of lumbar sympathetic block (LSB) in patients with CRPS in the lower extremities, whose current pharmacological and non-pharmacological treatment is not satisfactory. LSB is performed three times with 20 ml 0, 25 % levobupivacaine in the area of the second lumbar vertebra. The procedure is performed under control of the fluoroscope. The control check-up was within two weeks and four weeks. The pain is evaluated with the visual analogue scale (VAS), and the mechanical allodynia is evaluated with a touch-test sensory evaluator. The patients took Tramadol HCI of 50 mg up to 400mg daily when needed. With altogether 24 patients a LSB was made. Before the first LSB the average VAS with the patient was 8.16, before the second LSB the average VAS with the patient was 5.29, and before the third LSB the average VAS with the patient was 4, 58. After two weeks the average VAS was 4.70, and after four weeks 4.83. With four patients no change in the pain intensity was recorded during the whole period of observation. Mechanic allodynia was present with eight patients before the first LSB and with five patients after four weeks. After 4 weeks of LSB in 37.5 % (9) the therapy was rated excellent, with 33.3 % (8) as very good, with 12.5 % (3) as satisfactory, and with 16.7 % (4) of the patients as unsatisfactory. LSB is a useful and important diagnostic-therapeutically procedure. Its value is particularly manifested in the lessening of pain, the lessening of allodynia as well as an improvement of the functions of the extremities.

pain; alodynia; lumbar sympathetic blocks

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