Ultrasound-Guided Thoracic Paravertebral Block As A Sympathetic Blockade For Upper Extremity Neuropathic Pain: A Prospective Pilot Study

Purpose: Ultrasound-guided thoracic paravertebral block (US-TPVB) is considered a treatment option for the management of acute pain in various pain-related conditions. We conducted a prospective pilot study to evaluate the possibility of US-TPVB as a sympathetic blockade in patients with neuropathic pain disorders in the upper extremities.Patients and Methods: A total of 12 patients underwent US-TPVB between the T2 and T3 paravertebral space with 10 mL of 1% mepivacaine. The temperature change (degrees C) before and after the procedure was compared between the ipsilateral and contralateral hands. We counted the proportion of patients showing a temperature increase >= 1.5 degrees C and compared a change in the pain intensity before and after the procedure.Results: The median increase in the temperature change between the ipsilateral and contralateral hands was 1.54 degrees C (interquartile range, 1.28- 2.20). There were seven patients (58.3%) who showed a temperature difference >= 1.5 degrees C between both hands after the US-TPVB. Eleven patients (91.7%) reported a reduction in pain according to the score on the 11-point numerical rating scale. No serious complications relevant to the procedure were reported.Conclusion: US-TPVB could be a useful technique for sympathetic blockade in patients with upper extremity pain.