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Related Experiment Videos

Sympathectomy for neuropathic pain.

A Mailis1, A Furlan

  • 1Department of Medicine, Comprehensive Pain Program, 399 Bathurst Street, Fell Pavillion 4B-174, Toronto, Ontario, Canada, M5T 2S8. angela.mailis@uhn.on.ca

The Cochrane Database of Systematic Reviews
|June 14, 2003
PubMed
Summary

Surgical and chemical sympathectomy for neuropathic pain is supported by low-quality evidence and may lead to significant complications. Further clinical trials are needed to determine the true effectiveness and risks of these procedures.

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Area of Science:

  • Neurology
  • Pain Management
  • Surgical Interventions

Background:

  • Neuropathic pain arises from nervous system lesions or dysfunction.
  • Conditions include phantom limb pain, post-stroke pain, and complex regional pain syndromes.
  • Historically, sympathectomy aimed to interrupt the sympathetic nervous system for pain relief.

Purpose of the Study:

  • To assess the efficacy of chemical and surgical sympathectomy for neuropathic pain.
  • To compare sympathectomy outcomes against no treatment, placebo, or conventional therapies.
  • To evaluate the influence of specific sympathectomy techniques on procedural outcomes.

Main Methods:

  • Searched MEDLINE, EMBASE, and Cochrane Library up to February 2003.
  • Included clinical trials and observational studies on sympathectomy for neuropathic pain.

Related Experiment Videos

  • Narrative synthesis was performed due to data heterogeneity; statistical pooling was not possible.

    • Main Results:

    • Four studies were included; one randomized trial was of low methodological quality.
    • Radiofrequency sympatholysis showed no advantage over phenol sympathectomy.
    • A modified technique yielded comparable sympatholysis to phenol with fewer complications.

    Conclusions:

    • Current practice of sympathectomy relies on weak evidence and uncontrolled studies.
    • Complications include pain exacerbation, new pain syndromes, and abnormal sweating.
    • More high-quality clinical trials are essential to establish effectiveness and risks.