Lumbar Sympathetic Block

Published on January 2, 2012 by in Procedures

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Lumbar Sympathetic Block (LSB): This is a “nerve block” or injection of local anesthetic +/- steroid into the “sympathetic nerve” bundle that is located along both sides of your spinal column.
Indications for a Lumbar Sympathetic Block (LSB): This is an excellent injection for patients suffering lower extremity pain (i.e. leg/foot) due to a sympathetically mediated pain, such as Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS). The injection will reduce not only pain, but swelling, color changes, and sweating associated with this very painful condition. This nerve block is also used for patients suffering from Shingles related pain of the lower trunk (lower body) or lower extremity (i.e. leg/foot).
Technique: At SCCPM, lumbar sympathetic blocks are performed at the surgery center under live x-ray (fluoroscopy) for safety and accuracy.  The doctor will usually order IV sedation (i.e. “twilight sleep”) as an option for your comfort.  You will be checked in at the surgery center and brought into the operating suite, where you will be greeted by the doctor and registered nurse.  After placing monitors (e.g. blood pressure cuff, EKG, pulse oximeter, etc) on you, the nurse will give you IV sedation (if ordered).  Afterwards, the doctor will begin by “numbing” the injection site (in your lower back, close to the spine) with a local anesthetic.  Afterward, with the aid of the fluoroscope, Dr. Lee will perform the actual injection(s), in which a local anesthetic +/- steroid combination is injected.  After appropriate monitoring, you will then be transferred to the recovery unit before going home with a family member or friend.  You are encouraged to “take it easy” for the rest of the day, and to follow the post-procedure instructions ordered by Dr. Lee.  You will be able to resume your normal activities the next day.
Pain Relief Response and Duration: Most patients can expect a response at the first injection. In fact, the local anesthetic will usually provide relief immediately. The steroid medication is meant to prolong and improve the relief with the local anesthetic. You may require more than one injection for long term relief, depending on the severity and duration of your pain. You and Dr. Lee will decide exactly on the number and course of your treatment. Like any medication, the local anesthetic and steroid will “wear off” with time and you may require repeat injection(s). For most patients, one or a series of injections will allow pain relief for months and even a year or more. Unfortunately, Dr. Lee will not be able to predict your response as each patient’s disorder and severity is unique.

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