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Interscalene blocks for chronic upper extremity pain
J J Gibbons1, P R Wilson, T J Lamer
1Department of Anesthesiology, St. Louis University School of Medicine, Missouri 63110-0250.
The Clinical Journal of Pain
|September 1, 1992
Summary
Interscalene block (ISB) effectively treated chronic upper extremity pain in 25 patients, improving pain and range of motion. ISB showed comparable or superior results to stellate ganglion block (SGB) for reflex sympathetic dystrophy.
Area of Science:
- Pain Medicine
- Neurology
- Anesthesiology
Background:
- Chronic upper extremity pain significantly impacts quality of life.
- Interscalene block (ISB) and stellate ganglion block (SGB) are used for pain management.
- Reflex sympathetic dystrophy (RSD)/causalgia is a challenging chronic pain condition.
Purpose of the Study:
- To evaluate the efficacy of interscalene block (ISB) for chronic upper extremity pain.
- To compare ISB with stellate ganglion block (SGB) in patients with RSD/causalgia.
- To explore the role of somatic and sympathetic blockade in pain treatment.
Main Methods:
- A study involving 25 patients with chronic upper extremity pain.
- Utilized an RSD score for patient categorization.
- Administered interscalene block (ISB) and compared outcomes with stellate ganglion block (SGB) where applicable.
Main Results:
- 17 out of 25 patients reported reduced pain following ISB.
- 14 patients experienced an increased range of motion in the affected limb.
- Patients with RSD/causalgia and other chronic pain conditions showed improvement.
Conclusions:
- Interscalene block (ISB) is an effective treatment for chronic upper extremity pain.
- ISB demonstrated comparable or potential advantages over stellate ganglion block (SGB) for RSD/causalgia.
- Somatic and sympathetic blockade play a crucial role in managing chronic pain conditions.