Sympathetic Blocks for Sympathetic Pain - 06/05/22

Doi : 10.1016/j.pmr.2022.02.002

Melissa E. Phuphanich, MD, MS ^a,^⁎ , Quinn Wonders Convery, PharmD, BCPS ^a,^b, Udai Nanda, DO ^a,^c,^d, Sanjog Pangarkar, MD ^a,^e,^f
^a Physical Medicine and Rehabilitation Department (117), Veterans Administration Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
^b Department of Pharmacy, VA Greater Los Angeles Health Care System, Los Angeles CA, USA
^c Headache Center of Excellence, Department of Physical Medicine and Rehabilitation, Interventional Pain Service, VA Greater Los Angeles Health Care System, Los Angeles CA, USA
^d Pain Medicine Fellowship Program, Division of Physical Medicine and Rehabilitation, Department of Medicine, University of California Los Angeles- UCLA, Los Angeles, CA, USA
^e Inpatient and Interventional Pain Service, Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles CA, USA
^f Division of Physical Medicine and Rehabilitation, Department of Medicine, University of California Los Angeles- UCLA, Los Angeles, CA, USA

^∗Corresponding author. Physical Medicine and Rehabilitation Department (117), Veterans Administration Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073.Physical Medicine and Rehabilitation Department (117)Veterans Administration Greater Los Angeles Healthcare System11301 Wilshire BoulevardLos AngelesCA90073

Résumé

The sympathetic nervous system (SNS) is an integral component of the body’s response to stress. Once activated, the SNS has broad-reaching effects on multiple organ systems that modulate pain, behavior, and mood. Blockade of the system can improve pain associated with multiple etiologies, including vascular, visceral, and neuropathic pain. Multiple techniques are available to block the SNS and provide options that improve analgesia and can be individualized to a particular patient’s needs and disease state.

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Keywords : Sympathetic blocks, Sympathetic neurolysis, Sympathetic pain, Sympathetically maintained pain, Neuropathic pain, Vascular pain