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A Retrospective Evaluation of the Effectiveness of Thoracic Sympathetic Block: A Three-Year Experience
Dostali Aliyev1, İbrahim Aşık2
1Department of Anesthesiology and Reanimation, Division of Algology, Faculty of Medicine, Tobb Etü Hospital, 06510 Ankara, Turkey.
Background:
Thoracic sympathetic block (TSB) is an interventional pain management technique commonly used in the treatment of chronic pain conditions associated with sympathetic nervous system dysfunction. Its effectiveness in patients who are refractory to conservative therapies remains clinically important. This study aims to retrospectively evaluate the effectiveness and safety of fluoroscopy-guided thoracic sympathetic block in patients with chronic pain who did not achieve adequate relief with conservative treatment modalities. This study provides real-world 12-month follow-up data using both the Numeric Rating Scale and the McGill Pain Questionnaire to enable a multidimensional assessment of long-term treatment outcomes.
Study Design:
Retrospective.
Methods:
A total of 22 patients who presented to the Algology Polyclinic at Ankara University's İbn-i Sina Hospital between 2017 and 2021, had undergone thoracic sympathetic block, had a NRS score of ≥7, and had completed the McGill Pain Questionnaire, were included in this study. Interventional procedures were performed under fluoroscopic guidance. NRS and MPQ scores were recorded before the procedure and at the 1st, 6th, and 12th months post-intervention. Statistical analysis was performed using the Paired Samples t-test. The primary outcome was the change in NRS score from baseline to 12 months after the procedure. Secondary outcomes included changes in NRS and MPQ scores.
Results:
Of the participants, 54.5% were diagnosed with CRPS, 27.3% with postherpetic neuralgia, and 18.2% with malignancy. The mean NRS score decreased significantly from 8.59 pre-intervention to 2.05 in the 12th month after the procedure (p < 0.001). Similarly, MPQ scores showed a significant reduction. No procedure-related complications were observed.
Conclusions:
Fluoroscopy-guided thoracic sympathetic block is a safe and effective interventional option for long-term pain control in patients with chronic pain syndromes, particularly those with complex regional pain syndrome, postherpetic neuralgia, and malignancy-related pain.
