ABSTRACTS

Introduction: Complex Regional Pain Syndrome (CRPS) is a neuropathic pain syndrome (1). Continuous Stellate Ganglion (CSG) block has proven its efficacy in the management of CRPS in upper limb (2). Continuous Brachial Plexus block has also been used, which acts by blocking both sympathetic and somatic innervation (3). This study aims to compare the efficacy and feasibility of Continuous Infraclavicular Brachial Plexus (CIBP) and CSG in CRPS Type I in upper limb with bupivacaine. Methods and Materials: In this randomized, prospective, non-blinded study, 30 patients were enrolled after institutional ethical committee approval. CSG block was given through a 20 G IV cannula and CIBP block was given through contiplex catheter. After the procedure all patients were observed for 24 hrs and then sent home with the catheter in situ. 0.125% bupivacaine was delivered by means of a rate specific ambulatory elastomeric pump attached to the catheters. In first 24 hrs patient was assessed at 6 min, 30 min, 2 hr, 12 hr and 24 hr and after 24 hrs all patients were assessed every day for 1 week and then every week for 1 month for VAS, Neuropathic Pain Scale Score (NPSS), Plethysmography, Telethermometry, Edema score, Range of motion. Results: There was no statistical difference in demographic data. Sympatholysis was comparable in both groups. The peak onset of action in CSG group was at around 12 hrs and in CIBP group it was as early as 30 minutes. There was statistically significant decrease in pain scores with time within the group. Patients in CIBP showed clinically significant improvement in the range of motion in the distal joints.