Change in pulse transit time in the lower extremity after lumbar sympathetic ganglion block: an early indicator of successful block
نویسندگان
چکیده
Objective To investigate the change in pulse transit time (PTT)-time between the electrocardiographic R wave and the highest point of the corresponding plethysmographic wave-after lumbar sympathetic ganglion block (LSGB) and evaluate PTT as an indicator of successful LSGB. Methods Sixteen cases of sympathetically mediated lower extremity neuropathic pain treated with LSGB were studied. Correlations between the changes in PTT and temperature were used to identify the cutoff point indicating successful LSGB. Results PTT rate of change at 5 min relative to the baseline PTT (dPTT5/PTT0) significantly correlated positively with the temperature change at 20 min (correlation coefficient 0.734). The dPTT5/PTT0 ratios of the Success and Failure groups were 6.46 ± 2.81% and 2.77 ± 1.72%, respectively. The dPTT5/PTT0 cutoff indicating successful LSGB, based on receiver operating characteristic curve analysis, was 4.23%. Conclusion PTT measurement 5 min after local anesthetic injection was an early, objective indicator of successful or failed LSGB.
منابع مشابه
Lumbar Sympathetic Block for resistant to treatment causalgia in patient with opioid dependence.
Abstract Background & Aim: Lumbar sympathetic block is a commonly used technique for sympathetically mediated pain in lower extrimity. Causalgia (CRPS type 2 ) is also accepted to be associated with sympathetic system activation. Treatment of this condition is difficult, especially when the patient has opioid dependency. there has not been any report regarding lower-extremity lumbar sympathet...
متن کاملThe prolongation of pulse transit time after a stellate ganglion block: An objective indicator of a successful block
BACKGROUND An objective marker of successful stellate ganglion block (SGB) does not exist. Horner syndrome, which is currently used to determine the effect of SGB, is sometimes ambiguous. OBJECTIVE To investigate the change in pulse transit time (PTT) after SGB, and to evaluate the utility of PTT as an objective measure of successful SGB. METHODS Eight patients (34 to 62 years of age) under...
متن کاملSuccessful Treatment of Severe Sympathetically Maintained Pain Following Anterior Spine Surgery
Sympathetic dysfunction is one of the possible complications of anterior spine surgery; however, it has been underestimated as a cause of complications. We report two successful experiences of treating severe dysesthetic pain occurring after anterior spine surgery, by performing a sympathetic block. The first patient experienced a burning and stabbing pain in the contralateral upper extremity o...
متن کاملRetention of finger blood flow against postural change as an indicator of successful sympathetic block in the upper limb
BACKGROUND Sympathetic block in the upper limb has diagnostic, therapeutic and prognostic utility for disorders in the upper extremity that are associated with sympathetic disturbances. Increased skin temperature and decreased sweating are used to identify the adequacy of sympathetic block in the upper limb after stellate ganglion block (SGB). Baroreflexes elicited by postural change induce a r...
متن کاملEvidence-based interventional pain medicine according to clinical diagnoses. 16. Complex regional pain syndrome.
Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy is a pain syndrome with an unclear pathophysiology and unpredictable clinical course. The disease is often therapy resistant, the natural course not always favorable. The diagnosis of CRPS is based on signs and symptoms derived from medical history and physical examination. Pharmacological pain management and ...
متن کامل