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Bilateral pain relief after unilateral thoracic percutaneous sympathectomy
1Department of Anesthesia, Sunnybrook & Women's College Health Sciences Centre, University of Toronto, Ontario M4N 3M5, Canada. mgofeld@rogers.com
Purpose:
To present a case of unexpected bilateral pain relief following unilateral thoracic percutaneous sympathectomy.
Clinical Findings:
We present a case report where severe ischemic pain due to paraneoplastic Raynaud's syndrome with distal gangrene was successfully treated by means of percutaneous thoracic sympathectomy. A unilateral T2, T3 radiofrequency sympathectomy combined with small volume phenol injection resulted in unexpected bilateral pain relief.
Conclusion:
Our observations from this case report suggest a possible crossover of sympathetic innervation at the cervical and thoracic levels. Percutanenous thoracic radiofrequency sympathectomy is a feasible option for the treatment of refractory ischemic upper limb pain.
