Abstract

Thoracic sympathetic ganglion block is useful in the evaluation and management of sympathetically mediated pain of the upper thorax, chest wall, and thoracic and upper abdominal viscera. Thoracic sympathetic ganglion block with local anesthetic can be used as a diagnostic tool when differential neural blockade is performed on an anatomic basis in the evaluation of chest, thoracic, and upper abdominal pain. If destruction of the thoracic sympathetic chain is being considered, this technique can be used in a prognostic manner to indicate the degree of pain relief that the patient may experience. In the past, this block was used to treat intractable cardiac and abdominal angina. Thoracic sympathetic ganglion block with local anesthetic is also useful in the treatment of post-thoracotomy pain, acute herpes zoster, palmar hyperhidrosis, postherpetic neuralgia, and phantom breast pain after mastectomy. Destruction of the thoracic sympathetic chain is indicated for the palliation of pain syndromes that have temporarily responded to thoracic sympathetic blockade with local anesthetic.

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