OBJECTIVE: The sympathetic nervous system has a recognized role in transmission of pain, and the lumbar sympathetic blockade is intended to provide analgesia. We share our experiences of lumbar sympathetic blockade in the treatment of cancer-related pain. METHODS: We performed a retrospective analysis of patients with cancer-related pain in the back, abdomen, pelvis, or legs treated at Memorial Sloan Kettering Cancer Center between 2000 and 2018 undergoing lumbar sympathetic blockade at L2 or L3. Blocks were accomplished by injection of local anesthetic or local anesthetic with steroid under fluoroscopy. We measured numerical rating scale scores, percent relief, and relief time. The primary end point was defined as "effective" or "ineffective" pain relief. Effective pain relief was defined as ≥30% relief for at least one day. RESULTS: We identified 124 data points of lumbar sympathetic blockade at L2 or L3, of which 57 were with complete data and used for analysis. Peri-injection, 42 data points had active disease whereas 15 were in remission. Lumbar sympathetic blockade was 67% effective in the back pain cohort, 82% effective in the abdominopelvic pain cohort, and 75% effective in the leg pain cohort. Seventeen data points went on to neurolysis, two to neuromodulation, and eight to intrathecal pump implantation. CONCLUSIONS: Lumbar sympathetic blockade is effective for back, abdominopelvic, and leg pain related to cancer and its treatments. Future research should be aimed at refining its role within multimodal pain management.
OBJECTIVE: The sympathetic nervous system has a recognized role in transmission of pain, and the lumbar sympathetic blockade is intended to provide analgesia. We share our experiences of lumbar sympathetic blockade in the treatment of cancer-related pain. METHODS: We performed a retrospective analysis of patients with cancer-related pain in the back, abdomen, pelvis, or legs treated at Memorial Sloan Kettering Cancer Center between 2000 and 2018 undergoing lumbar sympathetic blockade at L2 or L3. Blocks were accomplished by injection of local anesthetic or local anesthetic with steroid under fluoroscopy. We measured numerical rating scale scores, percent relief, and relief time. The primary end point was defined as "effective" or "ineffective" pain relief. Effective pain relief was defined as ≥30% relief for at least one day. RESULTS: We identified 124 data points of lumbar sympathetic blockade at L2 or L3, of which 57 were with complete data and used for analysis. Peri-injection, 42 data points had active disease whereas 15 were in remission. Lumbar sympathetic blockade was 67% effective in the back pain cohort, 82% effective in the abdominopelvic pain cohort, and 75% effective in the leg pain cohort. Seventeen data points went on to neurolysis, two to neuromodulation, and eight to intrathecal pump implantation. CONCLUSIONS: Lumbar sympathetic blockade is effective for back, abdominopelvic, and leg pain related to cancer and its treatments. Future research should be aimed at refining its role within multimodal pain management.
Authors: Frank van Eijs; Michael Stanton-Hicks; Jan Van Zundert; Catharina G Faber; Timothy R Lubenow; Nagy Mekhail; Maarten van Kleef; Frank Huygen Journal: Pain Pract Date: 2010-08-27 Impact factor: 3.183
Authors: Thomas J Smith; Peter S Staats; Timothy Deer; Lisa J Stearns; Richard L Rauck; Richard L Boortz-Marx; Eric Buchser; Elena Català; David A Bryce; Patrick J Coyne; George E Pool Journal: J Clin Oncol Date: 2002-10-01 Impact factor: 44.544
Authors: David Hao; Shawn Sidharthan; Juan Cotte; Mary Decker; Mariam Salisu-Orhurhu; Dare Olatoye; Jay Karri; Jonathan M Hagedorn; Peju Adekoya; Charles Odonkor; Amitabh Gulati; Vwaire Orhurhu Journal: Curr Pain Headache Rep Date: 2021-05-07