Skip to main content
SpringerLink
Log in
Book cover

Treatment of Chronic Pain by Interventional Approaches pp 207–218Cite as

Thoracic and Lumbar Sympathetic Nerve Block and Neurolysis

  • Chapter
  • First Online:

  • 2417 Accesses

Abstract

Sympathetic blockade of the thoracic and lumbar regions has been long described in the medical literature; initial techniques for a percutaneous thoracic block (paravertebral approach) were documented by Kappis in 1919. Earlier descriptions which postulated the role of the sympathetic system in the development and maintenance of neuropathic pain are detailed in the medical literature of the early 1900s. The sympathetic contribution to so-called causalgia was theorized in 1916 by Leriche, who argued that periarterial excision of sympathetic fibers may be of therapeutic benefit in relieving pain.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Kappis M. Sensibilitt und local ansthesie in chirurgischen gebiet der bauchhole mit besonderen bercksichtigung der splanchnichusansthesie. Bruns Beitr Klin Cher. 1919;15:161.

    Google Scholar 

  2. Finch P. Sympathetic neurolysis. In: Raj PP, editor. Textbook of regional anesthesia. Churchill Livingstone in cooperation with W B Saunders New York; 2002, p. 667–85.

    Google Scholar 

  3. Skabelund C, Racz G. Indications and technique of thoracic 2 and thoracic 3 neurolysis. Curr Rev Pain. 1999;3:400–5.

    Article  Google Scholar 

  4. Marhold F, et al. Thoracoscopic and anatomic landmarks of Kuntz’s nerve: implications for sympathetic surgery. Ann Thorac Surg. 2008;86:1653–8.

    Article  PubMed  Google Scholar 

  5. Ohseto K. Efficacy of thoracic sympathetic ganglion block and prediction of complications: clinical evaluation of the anterior paratracheal and posterior paravertebral approaches in 234 patients. J Anesth. 1992;6(3):316–31.

    Article  CAS  PubMed  Google Scholar 

  6. Wilkinson HA. Radiofrequency percutaneous upper-thoracic sympathectomy. Technique and review of indications. N Engl J Med. 1984;311(1):34–6.

    Article  CAS  PubMed  Google Scholar 

  7. Cowie B, et al. Ultrasound-guided thoracic paravertebral blockade: a cadaveric study. Anesth Analg. 2010;110(6):1735–9.

    Article  PubMed  Google Scholar 

  8. Stanton-Hicks M. Thoracic sympathetic block: a new approach. Tech Reg Anesth Pain Manag. 2001;5(3):94–8.

    Article  Google Scholar 

  9. Raj PP, et al. Interventional pain management: image-guided procedures. Philadelphia: Saunders Elsevier; 2008.

    Google Scholar 

  10. Fishman SM, Ballantyne JC, Rathmell JP. Bonica’s management of pain, in various chapters. Philadelphia: Lippincott Williams & Wilkins; 2009.

    Google Scholar 

  11. Lamer T. Sympathetic nerve blocks. In: Regional anesthesia and analgesia. Philadelphia: WB Saunders; 1996. p. 357–84.

    Google Scholar 

  12. Brown D. Atlas of regional anesthesia, in atlas of regional anesthesia. Philadelphia: Saunders Elsevier Publishing; 2006.

    Google Scholar 

  13. Day M. Sympathetic blocks: the evidence. Pain Pract. 2008;8(2):98–109.

    Article  PubMed  Google Scholar 

  14. Loeser JD, Bonica JJ. Bonica’s management of pain. 3rd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. p. xxii, 2178 p.

    Google Scholar 

  15. Cowley RA, Yeager GH. Anatomic observations on the lumbar sympathetic nervous system. Surgery. 1949;25(6):880–90.

    CAS  PubMed  Google Scholar 

  16. Gray H, Goss CM. Anatomy of the human body. 29th ed. Philadelphia: Lea & Febiger; 1973. p. xvii, 1466 p.

    Google Scholar 

  17. Leriche R. L’anesthesie isolee du ganglion etoile: sa technique, ses indications, ses resultats. Presse Med. 1934;42:849–50.

    Google Scholar 

  18. Meier PM, et al. Lumbar sympathetic blockade in children with complex regional pain syndromes: a double blind placebo-controlled crossover trial. Anesthesiology. 2009;111(2):372–80.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Kramis RC, Roberts WJ, Gillette RG. Post-sympathectomy neuralgia: hypotheses on peripheral and central neuronal mechanisms. Pain. 1996;64(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  20. Cousins MJ, Bridenbaugh PO. Neural blockade in clinical anesthesia and management of pain. 2nd ed. Philadelphia: Lippincott; 1988. p. xix, 1171 p.

    Google Scholar 

  21. Heindel W, et al. CT-guided lumbar sympathectomy: results and analysis of factors influencing the outcome. Cardiovasc Intervent Radiol. 1998;21(4):319–23.

    Article  CAS  PubMed  Google Scholar 

  22. Tran KM, et al. Lumbar sympathetic block for sympathetically maintained pain: changes in cutaneous temperatures and pain perception. Anesth Analg. 2000;90(6):1396–401.

    Article  CAS  PubMed  Google Scholar 

  23. Cepeda MS, Carr DB, Lau J. Local anesthetic sympathetic blockade for complex regional pain syndrome. Cochrane Database Syst Rev. 2005;4:CD004598.

    PubMed  Google Scholar 

  24. Cousins MJ, et al. Neurolytic lumbar sympathetic blockade: duration of denervation and relief of rest pain. Anaesth Intensive Care. 1979;7(2):121–35.

    CAS  PubMed  Google Scholar 

  25. Froysaker T. Lumbar sympathectomy in impending gangrene and foot ulcer. Scand J Clin Lab Invest Suppl. 1973;128:71–2.

    CAS  PubMed  Google Scholar 

  26. Fyfe T, Quin RO. Phenol sympathectomy in the treatment of intermittent claudication: a controlled clinical trial. Br J Surg. 1975;62(1):68–71.

    Article  CAS  PubMed  Google Scholar 

  27. Haimovici H, Steinman C, Karson IH. Evaluation of lumbar sympathectomy. Advanced occlusive arterial disease. Arch Surg. 1964;89:1089–95.

    Article  CAS  PubMed  Google Scholar 

  28. Hughes-Davies DI, Redman LR. Chemical lumbar sympathectomy. Anaesthesia. 1976;31(8):1068–75.

    Article  CAS  PubMed  Google Scholar 

  29. Mashiah A, et al. Phenol lumbar sympathetic block in diabetic lower limb ischemia. J Cardiovasc Risk. 1995;2(5):467–9.

    Article  CAS  PubMed  Google Scholar 

  30. Myers KA, Irvine WT. An objective study of lumbar sympathectomy-II. Skin ischaemia. Br Med J. 1966;1(5493):943–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  31. Rosen RJ, et al. Percutaneous phenol sympathectomy in advanced vascular disease. AJR Am J Roentgenol. 1983;141(3):597–600.

    Article  CAS  PubMed  Google Scholar 

  32. Strand L. Lumbar sympathectomy in the treatment of peripheral obliterative arterial disease. An analysis of 167 patients. Acta Chir Scand. 1969;135(7):597–600.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesiology and Pain Clinic, Rochester Methodist Hospital, Mayo Clinic, 1200 First Street S.W., Rochester, MN, 55905, USA

    Tim J. Lamer M.D. & Jason S. Eldrige M.D.

  2. Mayo College of Medicine, Rochester, MN, USA

    Tim J. Lamer M.D.

Authors
  1. Tim J. Lamer M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason S. Eldrige M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tim J. Lamer M.D. .

Editor information

Editors and Affiliations

  1. President and CEO, Clinical Professor of Anesthesiology, The Center for Pain Relief, West Virginia University School of Medicine, Charleston, West Virginia, USA

    Timothy R. Deer

  2. Clinic Chief, Clinical Associate Professor, Department of Anesthesiology, Stanford Pain Medicine Center, Redwood City, CA, USA, and Stanford University School of Medicine, Stanford, California, USA

    Michael S. Leong

  3. Department of Anesthesiology, Orthopedic Anesthesia, Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA

    Asokumar Buvanendran

  4. Center for Interventional Pain & Spine, DE and Bryn Mawr, Newark, Pennsylvania, USA

    Philip S. Kim

  5. President, National Institute of Pain, Tampa, Florida, USA

    Sunil J. Panchal

Rights and permissions

Reprints and permissions

Copyright information

© 2015 American Academy of Pain Medicine

About this chapter

Cite this chapter

Lamer, T.J., Eldrige, J.S. (2015). Thoracic and Lumbar Sympathetic Nerve Block and Neurolysis. In: Deer, T., Leong, M., Buvanendran, A., Kim, P., Panchal, S. (eds) Treatment of Chronic Pain by Interventional Approaches. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1824-9_21

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-1824-9_21

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1823-2

  • Online ISBN: 978-1-4939-1824-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation