Comparison Between Morphine and Local Anesthetic Injections of Stellate and Celiac Ganglia in Chronic Pain Syndromes
Ten patients with upper extremity pain suggestive of reflex sympathetic dystrophy received stellate ganglion injections with local anaesthetic (lidocaine hydrochloride - 6 ml of a 2% solution) or narcotic (morphine sulfate - 2 mg in 6 ml normal saline). All patients demonstrated signs of sympathetic blockade (Horner’s sign, increased temperature of the upper extremity, etc.) after lidocaine injection. No patient demonstrated any sign of sympathetic blockade or systemic narcotic effects after morphine injection. All patients who obtained significant pain relief with either drug (eight) rated the morphine injection as being “better” (i.e. more profound, longer lasting, fewer side effects), and they preferred reinjection with morphine. Similarly, three patients with chronic abdominal visceral pain were given celiac ganglion injections with local anaesthetic (bupivacaine hydrochloride 30 ml of 0.25% solution) or narcotic (morphine sulfate - 6 mg in 30 ml normal saline). These three patients obtained relief comparable in onset, intensity, and duration with the two injections.
KeywordsPain Relief Sympathetic Ganglion Epidural Morphine Reflex Sympathetic Dystrophy Morphine Injection
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