botulinum toxin sympathetic block -- anyone doing this?

[oreosandsake]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763598/

Ann Neurol. 2009 Mar;65(3):348-51. doi: 10.1002/ana.21601.
Sympathetic block with botulinum toxin to treat complex regional pain syndrome.
Carroll I1, Clark JD, Mackey S.
Author information

• 1Department of Anesthesiology, Stanford University School of Medicine, Stanford, CA 94304-1573, USA. [email protected]

Complex regional pain syndrome is a refractory pain condition with few tested therapies. We hypothesized that botulinum toxin A (BTA) would prolong analgesia after sympathetic blocks in patients with complex regional pain syndrome. We compared the duration of standard lumbar sympathetic block (LSB) with bupivacaine to LSB with bupivacaine and BTA in nine patients with refractory complex regional pain syndrome. Median time to analgesic failure was 71 (95% confidence interval, 12-253) days after LSB with BTA compared with fewer than 10 days (95% confidence interval, 0-12) after standard LSB (log-rank, p < 0.02). BTA profoundly prolonged the analgesia from sympathetic block in this preliminary study.


on a separate note, I saw in the PMR board book that suprasystolic BP cuff leading to decreased pain in the affected limb can be used to diagnose CRPS

I could not find anything in pubmed, nor google for this except for references to the board book. Possibly a reference in german, but it was not translated into english.

is this validated and/or useful??

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