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Thoracic sympathetic ganglion blocks: real-world outcomes in 207 chronic pain patients
  1. Jeongsoo Kim1,
  2. Minsu Yun1,
  3. Andrew Hogyu Han2,
  4. Mohd Faeiz Pauzi3,
  5. Jae Hoon Jeong1,
  6. Yongjae Yoo1 and
  7. Jee Youn Moon1,4
  1. 1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
  2. 2Dept of Anesthesiology, Georgetown University School of Medicine, Washington, District of Columbia, USA
  3. 3Dept. of Anaesthesiology and Intensive Care, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia
  4. 4Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  1. Correspondence to Dr Jee Youn Moon, Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, 03080, Korea (the Republic of); jymoon0901{at}


Background Thoracic sympathetic ganglion block (TSGB) is a procedure to manage sympathetically maintained upper extremity pain (sympathetically maintained pain). To date, only a few studies have evaluated the clinical effectiveness of TSGB in pain medicine. This study investigated (1) the relationship between technical success of TSGB and pain reduction in patients with chronic upper extremity pain and (2) relevant clinical factors for a positive TSGB outcome.

Methods We retrospectively reviewed medical data in 232 patients who received TSGB from 2004 to 2020. Technical success and a positive outcome of TSGB were defined as a temperature increase of ≥1.5°C at 20 min and a pain reduction with ≥2 points on the 11-point Numerical Rating Scale at 2 weeks post-TSGB, respectively. Correlations were assessed using correlation coefficients (R), and multivariable regression model was used to identify factors relevant to TSGB outcomes.

Results 207 patients were ultimately analyzed; among them, 115 (55.5%) patients positively responded to TSGB, and 139 (67.1%) achieved technical success after TSGB. No significant relationship existed between the pain reduction and the temperature increase after TSGB (R=0.013, p=0.855). Comorbid diabetes (OR 4.200) and adjuvant intake (OR 3.451) were positively associated, and psychiatric comorbidity (OR 0.327) and pain duration (OR 0.973) were negatively associated with TSGB outcome.

Conclusions We found no significant association between the temperature increase and pain reduction after TSGB. Further studies are warranted to identify significant factors associated with TSGB outcomes in patients with complex regional pain syndrome and neuropathic pain diseases.

  • Upper Extremity
  • Complex Regional Pain Syndromes
  • Nerve Block
  • Treatment Outcome

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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  • Contributors Study design/planning: JYM, JK and YY. Acquisition of data: JK, MY, MFP and JHJ. Data analysis: JYM and JK. Writing the paper: JYM, JK and AHH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.