This procedure is performed in patients that are suspected of having lower extremity pain
mediated by sympathetic plexus pain fibers ( RSD, CRPS) , neuropathic pain, or pain caused
due to decrease in blood flow to the legs due to vascular disease.
This block has both diagnostic and therapeutic characteristics. An IV will be started in the preop area,
and the patient will be placed prone (face down) on the table. With the aid of a Live X-ray the desired
positions will be identified. A total of two to three levels need to be blocked depending on the approach
undertaken. Before injection of local anesthetics the correct position of the needles will be verified using
contrast solution under fluoroscopy.
A successful block is invariably characterized by an increase in temperature in the side the block
was performed. Pain relief should be appreciated if there is a sympathetically mediated component in
the patient’s symptoms. The procedure will take 30-45 minutes. After the completion of the procedure,
Band-Aids will be placed at the injection sites, and a nurse will monitor the blood pressure and pulse
and will review the discharge instructions with the patient before going home.
 | |  |
