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The purpose of this study is to compare the efficiency and safety of 2ml versus 5ml of local anesthetics used in stellate ganglion blocks for the treatment of complex regional pain syndrome of the arm.
To evaluate if 2ml of 0.2% ropivacaine is less effective in decreasing pain scores by more than 50% when compared to 5ml of 0.2% ropivacaine. To evaluate if 2ml of 0.2% ropivacaine is causes less side effects when compared to 5ml after a stellate ganglion block.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 5 | Experimental | stellate ganglion block with ropivacaine 0.2% 5 mL |
|
| Group 2 | Active Comparator | stellate ganglion block wit ropivacaine 0.2% 2 mL |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| stellate ganglion block with ropivacaine 0.2% 5 mL | Procedure | Each patient will undergo two stellate ganglion blocks and receive both volumes of local anesthetics in random order. The stellate ganglion blocks will be separated by 3 weeks in order to assure that no residual effects from the previous block will influence the results. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score | Evaluate the efficiency of stellate ganglion block in decreasing pain scores 24 hours after the procedure using a verbal numeric pain rating scale. | 24 hours after the stellate ganglion block |
| Measure | Description | Time Frame |
|---|---|---|
| Pain score | Evaluate the efficiency of stellate ganglion block in decreasing pain scores 7 days after the procedure using a verbal numeric pain rating scale. | 7 days after the stellate ganglion block |
| Pain score |
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of seizure during a stellate ganglion block | patient having seizure | within 30 minutes of performing the stellate ganglion block |
| Occurrence of hematoma after a stellate ganglion block | physician or patient identifying a neck hematoma |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Veronique Brulotte, MD | Maisonneuve-Rosemont Hospital | Principal Investigator |
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| stellate ganglion block wit ropivacaine 0.2% 2 mL | Procedure | Each patient will undergo two stellate ganglion blocks and receive both volumes of local anesthetics in random order. The stellate ganglion blocks will be separated by 3 weeks in order to assure that no residual effects from the previous block will influence the results. |
|
Evaluate the efficiency of stellate ganglion block in decreasing pain scores 14 days after the procedure using a verbal numeric pain rating scale.
| 14 days after the stellate ganglion block |
| Temperature increase in the ipsilateral arm | Evaluate the efficiency of stellate ganglion block on the increase in temperature of the ipsilateral arm using an infrared thermometer. The cutaneous temperature will be measured in order to determine the proportion of patients in each group reaching an increase of >1.5 C in the ipsilateral arm. | 1 hour after the procedure |
| Horner Syndrome | Evaluate the efficiency of stellate ganglion block to produce an ipsilateral Horner Syndrome as defined by a ptosis and miosis. Evaluate the proportion of patients in each group presenting an ipsilateral Horner syndrome. | 1 hour after the procedure |
| Occurrence of dysphagia after a stellate ganglion block | Patients describing having dysphagia after the stellate ganglion block | 1 hour after the procedure |
| Occurrence of hoarseness after a stellate ganglion block | patients describing having hoarseness after a stellate ganglion block | 1 hour after the procedure |
| Occurrence of foreign body sensation after a stellate ganglion block | patients describing having a foreign body sensation after the stellate ganglion block | 1h after the procedure |
| Occurrence of dyspnea after a stellate ganglion block | patients describing having dyspnea after a stellate ganglion block | 1h after the procedure |
| Occurrence of ipsilateral arm weakness after a stellate ganglion block | patients describing having ipsilateral arm weakness after a stellate ganglion block | 1h after the procedure |
| During the first 7 days after the procedure |
| Occurrence of pneumothorax after a stellate ganglion block | physician diagnosing a pneumothorax | During the first 7 days after the procedure |
| ID | Term |
|---|---|
| D020918 | Complex Regional Pain Syndromes |
| ID | Term |
|---|---|
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| D000077212 | Ropivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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