Chemical Lumbar Sympathectomy for Lower Limb Resting Pain/Nonhealing Ulcer Associated With Thromboangiitis Obliterans

Dr. Pramod Kumar Sharma; Dr. Alok Sharma; Dr. Suchi Sharma; Dr. S. P. Chittora

Volume : IX, Issue : IV, April - 2020

Chemical Lumbar Sympathectomy for Lower Limb Resting Pain/Nonhealing Ulcer Associated With Thromboangiitis Obliterans

Dr. Pramod Kumar Sharma, Dr. Alok Sharma, Dr. Suchi Sharma, Dr. S. P. Chittora

Abstract :

Aim:– This study was to assess the effectiveness of chemical lumbar sympathectomy in pain relieving and healing ischemic ulcer in patient of Thromboangiitis obliterans(TAO). Material and Method: 32 patients with resting pain, ischemic/gangrenous ulcer referred to pain clinic de department of anaesthesia Jhalawar Medical College, Jhalawar. These patients divided in 2 group–18 had buerger�s disease and remaining 14 are non buerger�s disease and planned for Chemical Lumbar sympathectomy using fluoroscopic guided by C–arm. 5ml of 2% lignocaine hydrochloride was instilled as LA. 22 gauge spinal needle, water soluble non–ionic contrast Iohexol 3%– 1.5 ml dye, 0.5% isobaric bupivacaine–2ml, 10% phenol– 1ml were used during procedure. Patient follow–up was done on next day, 3rd day and after 2,4, 8 and 12 weeks. Result: Outcome for improvement in resting pain were observed by 1–10 Numerical analogue score (NAS). There was significant decrease in pain score from 8.5�0.8 (preblock) to 4.1�1.2 (post block 3rd da day). By 12 week– 5patient decline to follow up, 21 (77.7%) of remaining 27 patients reported paipain relief & 17(62%) reported healing /decrease size of ulcer. Conclusion: Chemical Lumbar Sympathectomy provide safe and effective treatment for TAO patients with resting pain and promoting healing ulcer