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Sympathetic Blockade with Botulinum Toxin Tied to Pain Relief in Complex Regional Pain Syndrome: Study
South Korea: Lumbar sympathetic ganglion block using botulinum toxin type A raised the temperature of the affected foot for 3 months in patients with complex regional pain syndrome and also reduced the pain, reveals a recent study. The study was published in the February 2022 issue of the journal Anesthesiology.
The study was designed to test the hypothesis that botulinum toxin prolongs the duration of a lumbar sympathetic block measured through a sustained increase in skin temperature. Jee Youn Moon, Seoul National University Hospital, Seoul, Republic of Korea, and colleagues performed a randomized, double-blind, controlled trial to examine the clinical outcome of botulinum toxin type A for lumbar sympathetic ganglion block in patients with complex regional pain syndrome.
For this purpose, the researchers conducted lumbar sympathetic ganglion block in patients with lower-extremity complex regional pain syndrome using 75 IU of botulinum toxin type A (botulinum toxin group) and local anesthetic (control group).
The change in the relative temperature difference on the blocked sole compared with the contralateral sole at 1 postoperative month was the primary outcome. The 3-month changes in relative temperature differences, and the pain intensity changes were the secondary outcomes.
A total of 48 participants (N = 24/group) were randomly assigned.
Based on the study, the researchers found the following:
- The change in relative temperature increase was higher in the botulinum toxin group than in the control group (1.0°C ± 1.3 vs. 0.1°C ± 0.8, respectively), which was maintained at 3 months (1.1°C ± 0.8 vs. –0.2°C ± 1.2, respectively).
- Moreover, pain intensity was greatly reduced in the botulinum toxin group compared with the control group at 1 month (–2.2 ± 1.0 vs. –1.0 ± 1.6, respectively) and 3 months (–2.0 ± 1.0 vs. –0.6 ± 1.6, respectively).
- There were no severe adverse events pertinent to botulinum toxin injection.
"We found that compared with local anesthetic, injections of botulinum toxin type A onto the lumbar sympathetic ganglia increased temperature on the affected foot for 3 months," the authors wrote. This was accompanied by pain reduction and cold tolerance improvement. Moreover, it also improved aching and numbness."
Reference:
Yongjae Yoo, Chang-Soon Lee, Jungsoo Kim, Dongwon Jo, Jee Youn Moon; Botulinum Toxin Type A for Lumbar Sympathetic Ganglion Block in Complex Regional Pain Syndrome: A Randomized Trial. Anesthesiology 2022; 136:314–325 doi: https://doi.org/10.1097/ALN.0000000000004084
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751