Abstract
Lumbar sympathetic block is a procedure to interrupt the sympathetic output to the lower limbs. It is commonly indicated in sympathetic maintained pain, complex regional pain syndrome, and peripheral vascular disease. Both fluoroscopy and ultrasound imaging have been described for this procedure. The procedure can be performed for diagnostic, prognostic, and therapeutic indications.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Suggested Reading
Alexander JP. Chemical lumbar sympathectomy in patients with severe lower limb ischaemia. Ulst Med J. 1994;63(2):137.
Bandyk DF, Johnson BL, Kirkpatrick AF, Novotney ML, Back MR, Schmacht DC. Surgical sympathectomy for reflex sympathetic dystrophy syndromes. J Vasc Surg. 2002;35(2):269–77.
Bonica JJ. The management of pain. Philadelphia, PA: Lea & Febiger; 1953.
Bonica JJ. The management of pain. Philadelphia, PA: Lea & Febiger; 1990. p. 407–46, 915–66, 1047–72.
Bruehl S, Harden RN, Galer BS, Saltz S, Bertram M, Backonja M, et al. External validation of IASP diagnostic criteria for complex regional pain syndrome and proposed research diagnostic criteria. Pain. 1999;81(1):147–54.
Brunn F, Mandl F. Die paravertebrale Injektion zur Bekampfung visceraler Schmerzen. Wien Klin Wochenschr. 1924;37:511.
Crockett A, Panickar A. Role of the sympathetic nervous system in pain. Anaesth Intens Care Med. 2011;12(2):50–4.
Cross FW, Cotton LT. Chemical lumbar sympathectomy for ischemic rest pain: a randomized, prospective controlled clinical trial. Am J Surg. 1985;150(3):341–5.
Day M. Sympathetic blocks: the evidence. Pain Pract. 2008;8(2):98–109.
Dellon L, Andonian E, Rosson GD. Lower extremity complex regional pain syndrome: long-term outcome after surgical treatment of peripheral pain generators. J Foot Ankle Surg. 2010;49(1):33–6.
Dotson RM. Causalgia—reflex sympathetic dystrophy—sympathetically maintained pain: myth and reality. Muscle Nerve. 1993;16(10):1049–55.
van Eijs F, Stanton-Hicks M, Van Zundert J, Faber CG, Lubenow TR, Mekhail N, et al. 16. Complex regional pain syndrome. Pain Pract. 2011;11(1):70–87.
Elam M. What lies above and beyond the concept of “sympathetically maintained pain”? Clin Auton Res. 2001;11(6):331–3.
Feigl GC, Kastner M, Ulz H, Breschan C, Dreu M, Likar R. Topography of the lumbar sympathetic trunk in normal lumbar spines and spines with spondylophytes. Br J Anaesth. 2011;106(2):260–5.
Flamer D, Seib R, Peng P. Chapter 16. Complications of regional anesthesia in chronic pain therapy. In: Finucane BT, Tsui BCH, editors. Complications of regional anesthesia: principles of safe practice in local and regional anesthesia. Cham: Springer International Publishing; 2017.
Gibbs GF, Drummond PD, Finch PM, Phillips JK. Unravelling the pathophysiology of complex regional pain syndrome: focus on sympathetically maintained pain. Clin Exp Pharmacol Physiol. 2008;35(7):717–24.
Harden RN, Bruehl S, Galer BS, Saltz S, Bertram M, Backonja M, et al. Complex regional pain syndrome: are the IASP diagnostic criteria valid and sufficiently comprehensive? Pain. 1999;83(2):211–9.
Haynsworth RF, Noe CE. Percutaneous lumbar sympathectomy. A comparison of radiofrequency denervation versus phenol neurolysis. Anesthesiology. 1991;74(3):455–63.
Jackson TP, Gaeta R. Neurolytic blocks revisited. Curr Sci. 2008;12:7–13.
Kingery WS. A critical review of controlled clinical trials for peripheral neuropathic pain and complex regional pain syndromes. Pain. 1997;93:123–39.
Kirvelä O, Svedström E, Lundbom N. Ultrasonic guidance of lumbar sympathetic and celiac plexus block: a new technique. Reg Anesth. 1992;17(1):43.
Leriche R. De la causalgie envisagée comme une névrite du sympathique et de son traitement par la dénudation et l’excision des plexus nerveux péri-artériels. Presse Méd. 1916;24(l78–I80):I9.
Mailis-Gagnon A, Furlan AD. Sympathectomy for neuropathic pain. Cochrane Database Syst Rev. 2002;(1):CD002918.
Mandl F. Die Paravertebrale Injektion. Vienna: J Springer; 1926.
Manjunath PS, Jayalakshmi TS, Dureja GP, Prevost AT. Management of lower limb complex regional pain syndrome type 1: an evaluation of percutaneous radiofrequency thermal lumbar sympathectomy versus phenol lumbar sympathetic neurolysis—a pilot study. Anesth Analg. 2008;106(2):647–9.
Murata Y, Takahashi K, Yamagata M, et al. Variations in the number and position of human lumbar sympathetic ganglia and rami communicantes. Clin Anat. 2003;16:108–13.
Nath RK, Mackinnon SE, Stelnicki E. Reflex sympathetic dystrophy. The controversy continues. Clin Plast Surg. 1996;23(3):435–46.
O’Connell NE, Wand BM, McAuley J, Marston L, Moseley GL. Interventions for treating pain and disability in adults with complex regional pain syndrome. Cochrane Database Syst Rev. 2013;(4):CD009416.
Raj PP, Lou L, Erdine S, Staats PS, Waldman SD, Racz G, Hammer M, et al. Interventional pain management. London: Elsevier Health Sciences; 2008.
Rathmell JP, Nelson GJ. Atlas of image-guided intervention in regional anesthesia and pain medicine. Philadelphia, PA: Lippincott Williams & Wilkins; 2012.
Reid W, Watt JK, Gray RG. Phenol injection of the sympathetic chain. Br J Surg. 1970;57:45.
Roberts WJ. A hypothesis on the physiological basis for causalgia and related pains. Pain. 1986;24:297–311.
Ryu JH, Lee CS, Kim YC, Lee SC, Shankar H, Moon JY. Ultrasound-assisted versus fluoroscopic-guided lumbar sympathetic ganglion block: a prospective and randomized study. Anesth Analg. 2018;126(4):1362–8.
Standring S, Gray H. Gray’s anatomy: the anatomical basis of clinical practice. Amsterdam: Elsevier; 2015.
Stanton-Hicks M. Reflex sympathetic dystrophy: a sympathetically mediated pain syndrome or not? Curr Rev Pain. 2000;4(4):268–75.
Stanton-Hicks M, Jänig W, Hassenbusch S, Haddox J, Boas R, Wilson P. Reflex sympathetic dystrophy: changing concepts and taxonomy. Pain. 1995;63(1):127–33.
Straube S, Derry S, Moore RA, Cole P. Cervico-thoracic or lumbar sympathectomy for neuropathic pain and complex regional pain syndrome. Cochrane Database Syst Rev. 2013;9:CD002918.
Zechlinski JJ, Hieb RA. Lumbar sympathetic Neurolysis: how to and when to use? Tech Vasc Interv Radiol. 2016;19(2):163–8.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Vargas Silva, J.F., Peng, P. (2022). Lumbar Sympathetic Block. In: Jankovic, D., Peng, P. (eds) Regional Nerve Blocks in Anesthesia and Pain Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-88727-8_45
Download citation
DOI: https://doi.org/10.1007/978-3-030-88727-8_45
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-88726-1
Online ISBN: 978-3-030-88727-8
eBook Packages: MedicineMedicine (R0)