痛みと緩和のジャーナル

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Sympathetic Ganglion Block and Neridronate Infusion for Early Phase CPRS-I Treatment: Effects on Pain and Microcirculation

Gagliardi G and Ceccherelli F

CRPS can be described as a painful inflammatory condition that occurs in most cases after a traumatic lesion,
such as sprain or fracture. The main physiopathological elements involved in the genesis of CPRS-I are essentially:
autonomical nervous system activity, neurogenic inflammation and microvascular impairment. The aim of the study is
to investigate the effect of an integrated treatment, which consists of an anesthetic block of the sympathetic lumbar
chain and a neridronate infusion protocol, on pain and microcirculatory variations in patients affected by CPRS of lower
limb. Twelve patients affected by early stage CPRS-I with a duration of pain of 3 ± 1.2 months have been enrolled. They
have been treated with a neridronate infusion of 100 mg × 4 times over 10 days; and simultaneously, they underwent
an ipsilateral lumbar sympathetic nerve block. Pain intensity, function restoration and analisys of microcirculation using the LDF (laser doppler flowmeter) have been monitored. The results have shown a quick clinical improvement, with a reduction in pain severity and a restoration of microcirculation function. The association of neridornate infusion and sympathetic nerve block has been found to be effective and safe for early stage CPRS-I treatment.