RE “A Prospective, Randomized Cross-Over Trial of T2 Paravertebral Block as a Sympathetic Block in Complex Regional Pain Syndrome (CRPS)”

摘要

We read with great interest the article by YoungHoon Kim et al (1), which was informative and dis-cusses a novel idea for the management of complexregional pain syndrome (CRPS) in patients. The au-thors report superior clinical outcomes includinggreater sympatholytic property, greater pain reduc-tion immediately after the procedure, longer dura-tion of effect, and a higher subjective patient satisfac-tion scores with T2 PVB compared to stellate ganglionblocks (SGB) (1). The authors believe that T2 PVB canachieve more profound sympatholysis of the upperextremities than SGB alone (1). We are of the opinionthat T2 PVB simultaneously blocks the somatic nervesfibers (anterior and posterior ramus of the spinal in-tercostal nerves, brachial plexus, rami communicantsof T2 and nearby levels, as the paravertebral spacecommunicates medially with the epidural space andlaterally with the intercostal space) (2) and thus couldcontribute to the superior clinical outcome with T2PVB over SGB and this needs to be highlighted in thediscussion.