複合性局所疼痛症候群に対する胸部交感神経節ブロックの有効性


CRPS患者の胸部交感神経ブロック(thoracic sympathetic block:TSB)の鎮痛効果の評価.方法:標準的な薬物治療と理学療法を受けたCRPS-I 患者に追加治療として、無作為にTSB 又は対照治療を行う。臨床データ、痛みの強さおよび障害(Brief Pain Inventory-BPI), 痛みの特徴 (McGill Pain Questionnaire-MPQ), 神経症障害性の特徴 (Neuropathic Pain Symptom Inventory-NPSI), 気分, 上肢機能 (Disabilities of Arm, Shoulder and Hand-DASH)および生活の質を治療前、治療後1か月と12か月で評価。 結果:36人の患者(19 人の女性, 44.7±11.1歳) が治療を受ける (17人がTSB群). 治療1ヵ月後の痛みの強さの平均はTSB (3.5±3.2) は対照群 (4.8±2.7;p=0.249)と比較して差がない。しかし12か月の時点では, TSB 群の(3.47± 3.5)痛みの平均は対照群 (5.86± 2.9;p=0.046)より有意に低い。MPQの点数, 誘発された痛み症状のsubscores (NPSIおよび抑うつ点数 (HADS) はTSB群の方が対照群よりも治療1ヵ月後と12ヵ月後で有意に低い. 他の指標は治療の影響を受けない。生活の質はTSBではわずかしか改善しない。大きな副作用は起こらず。この所見を確かめるために、大きな多施設研究を行うべきである。
Pain. 2014 Aug 19. pii: S0304-3959(14)00374-1. doi: 10.1016/j.pain.2014.08.015. [Epub ahead of print]
Thoracic Sympathetic Block for the Treatment of Complex Regional Pain Syndrome Type I: A double-blind randomized controlled study.
de Oliveira Rocha R1, Teixeira MJ2, Yeng LT3, Cantara MG4, Faria VG5, Liggieri V6, Loduca A7, Müller BM8, da Silveira Souza AC9, de Andrade DC10.
•1Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: contato@drrobertorocha.com.br.
•2Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Neurosurgery Division, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: manoeljacobsen@gmail.com.
•3Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Physical Medicine, Department of Orthopedy, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: lintyeng@uol.com.br.
•4Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Physical Medicine, Department of Orthopedy, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: mirlenegardin@uol.com.br.
•5Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Physical Medicine, Department of Orthopedy, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: viviane_gentily@hotmail.com.
•6Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Physical Medicine, Department of Orthopedy, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: artsaude@hotmail.com.
•7Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: aloduca@uol.com.br.
•8Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: barbaram_muller@hotmail.com.
•9Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: andreacmssouza@gmail.com.
•10Pain Center, Department of Neurology, School of Medicine, University of São Paulo, São Paulo, Brazil; Instituto do Câncer do Estado de São Paulo Octávio Frias de Oliveira, university of São Paulo, Brazil. Electronic address: ciampi@usp.br.
[PR]

by fibromyalgia11 | 2014-09-01 23:53 | 複合性局所疼痛症候群
line

世界標準の線維筋痛症を専門家が説明します


by fibromyalgia11
line