NEUROLYTIC POSTERIOR THORACIC SYMPATHETIC BLOCK

Pre-Treatment Requirements

Prior to having the block, you will be admitted to Day Hospital for observation after the block.

An IV will be started and you will not be allowed to eat for 6 hours before having your block.

Indications

This block is indicated for relief of severe pain in sympathetically mediated pain of upper extremities, i.e., reflex sympathetic dystrophy or causalgia. It is also used for chest pain.

Procedure

This procedure is performed in the prone position (lying on your stomach) with a small amount of alcohol or aqueous phenol being injected in the carefully drawn out mark on your upper back.  The nerve killing medicine is injected under CT scanner guidance to make sure it is going into the area of optimal pain relief.  You will be face down on a table.  You will have an IV and routine monitors on.  You will move in and out of a doughnut shaped machine as special pictures are taken of the needle location. 

Please notify your doctor if you have difficulty or pain with breathing.

Possible Complications

… Pneumothorax (punctured or collapsed lung).

… Possible Horner's (droopy upper eyelid which may be permanent or transient).

… Respiratory and/or cardiac arrest.

… Slurred speech and/or seizures.

… Possible epidural or subarachnoid injection with resulting nerve injury.

… Injection site pain, which will usually disappear in 1-2 days.