PMID: 7537321Feb 1, 1995Paper

Lumbar neurolytic sympathetic blockades provide immediate and long-lasting improvement of painless walking distance and muscle metabolism in patients with severe peripheral vascular disease

Journal of Pain and Symptom Management
M GleimU Melchert

Abstract

Thirty patients with angiographically proven peripheral vascular disease (PVD) and intermittent claudication were treated with percutaneous lumbar neurolytic sympathetic blockade (NSB) using 1.5 mL ethanol 95%. Claudication had been progressive in all patients during conservative treatment. Median (range) painless walking distance increased from 95 (10-200) meters (m) before to 355 (25-1003) m immediately after NSB. Further improvement was seen during the 1-year follow-up, with two exceptions: one patient lost a leg after acute arterial embolism and another patient deteriorated after 6 months. In the latter case, a second NSB improved the walking distance again. One case of transient mild neuralgia of the L3 dermatome occurred. 31P-magnetic resonance investigations of the calf muscles before, during, and after a treadmill exercise were performed in seven patients: 1 week after NSB, the postexercise recovery of phosphocreatine was accelerated in all patients compared to the pre-NSB values. The accelerated recovery suggests an improved post-ischemic metabolic situation after chemical sympathectomy.

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Citations

Jan 1, 1995·Der Schmerz
Apr 23, 2004·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·C R GreenE Guerrero
Oct 3, 2006·Current Opinion in Anaesthesiology·B DonnerT Weiss

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