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Sympathetic block with botulinum toxin to treat complex regional pain syndrome
Author(s) -
Carroll Ian,
Clark J. David,
Mackey Sean
Publication year - 2009
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21601
Subject(s) - botulinum toxin , medicine , complex regional pain syndrome , block (permutation group theory) , anesthesia , mathematics , geometry
Complex regional pain syndrome is a refractory pain condition with few tested therapies. We hypothesized that botulinum toxin A (BTA) would prolong analgesia after sympathetic blocks in patients with complex regional pain syndrome. We compared the duration of standard lumbar sympathetic block (LSB) with bupivacaine to LSB with bupivacaine and BTA in nine patients with refractory complex regional pain syndrome. Median time to analgesic failure was 71 (95% confidence interval, 12–253) days after LSB with BTA compared with fewer than 10 days (95% confidence interval, 0–12) after standard LSB (log‐rank, p < 0.02). BTA profoundly prolonged the analgesia from sympathetic block in this preliminary study. Ann Neurol 2009;65:348–351