Efficacy of stellate ganglion block in the management of CRPS-not otherwise specified

Abstract

Background: Stellate ganglion block (SGB) is a well-established treatment option for CRPS (complex regional pain syndrome) type I. However, no studies have been conducted to study its efficacy in patients with CRPS-not otherwise specified (NOS). We conducted a study to evaluate the efficacy of SGB in decreasing pain and improving the functional use of the upper limb in patients with CRPS-NOS. Materials and Methods: We performed SGB on 24 patients with a diagnosis of CRPS-NOS at weekly intervals until 50% relief in pain and functional activity of the limb was achieved. Pain and functional ability of the limb were assessed by visual analog scale (VAS) disabilities of the arm, shoulder, and hand (DASH) scores, respectively. VAS and DASH scores were recorded before and 1 week after the procedure and the results were compared using appropriate statistical tests. The number of blocks required to achieve the desired effect was also noted in all the patients. Results: All the patients in our study showed significant improvement in VAS (P = 0.001) and DASH scores (P 12 weeks). This finding was statistically significant (P = 0.047). Conclusion: SGB used early in the course of disease improves pain and functional ability of the limb in patients with CRPS-NOS. We also presume that CRPS-NOS might be an initial stage of the full blown CRPS and hence can serve as a window period in identifying and treating patients early in the course of the disease. However, this finding needs to be substantiated by further studies.