The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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The Effects of Lumbar Sympathetic Ganglion Block in the Patients with Spinal Stenosis and the Skin Temperature Changes according to the Contrast Spread Patterns

요척주관 협착증 환자의 요부 교감신경 차단술의 효과 및 조영 양상에 따른 피부 체온의 변화

  • Hong, Ji Hee (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine) ;
  • Kim, Jin Mo (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine) ;
  • Kim, Ae Ra (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine) ;
  • Lee, Yong Chul (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine) ;
  • Kim, Sae Young (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine) ;
  • Kwon, Seung Ho (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine) ;
  • Oh, Min Ju (Department of Anesthesiology and Pain Medicine, Keimyung University School of Medicine)
  • 홍지희 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 김진모 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 김애라 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 이용철 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 김세영 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 권승호 (계명대학교 의과대학 동산의료원 마취통증의학교실) ;
  • 오민주 (계명대학교 의과대학 동산의료원 마취통증의학교실)
  • Received : 2009.06.30
  • Accepted : 2009.07.31
  • Published : 2009.08.01
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Abstract

Background: We hypothesized that if a fluoroscopic image of the lumbar sympathetic ganglion block (LSGB) showed the spread patterns of contrast at both the L2/3 and L4/5 disc areas, then this would demonstrate a more profound blockade effect because the spread patterns are close to sympathetic ganglia. In addition, we compared the effects of LSGB and transforaminal epidural steroid injection (TFESI) for the patients suffering with spinal stenosis. Methods: Eighty patients were divided into two groups (Group S: the patients treated with TFESI, Group L: the patients treated with LSGB). The patients of group L were classified into three groups (groups A, B and, C) according to their contrast spread pattern. The preblock and postblock temperature difference between the ipsilateral and contralateral great toe ($DT^{pre}$, $DT^{post}$, $^{\circ}C$), and the DTnet were calculated as follows. $DT^{net}$ = $DT^{post}$ - $DT^{pre}$. Results: Both group showed a significant reduction of the visual analogue score (VAS) and the Oswestry disability index (ODI) score. Only the patients of group L showed a significant increase of their walking distance (WD). Group A showed the most significant changes in the $DT^{post}$ ($6.1{\pm}1.2^{\circ}C$, P = 0.021), and the DTnet ($6.0{\pm}1.0^{\circ}C$, p = 0.023), as compared to group C. Conclusions: LSGB showed a similar effect on the VAS, and ODI, and a significant effect, on WD, compared with TFESI. Group A showed a significant sympatholytic effect, as compared to group C.

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References

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