Key result
Temporary sympathectomy with bupivacaine did not significantly reduce the frequency of angina episodes compared to saline placebo (p=0.18), although both groups combined experienced a 31% median reduction.
Why the study?
Does temporary sympathectomy with bupivacaine reduce angina episodes in patients with chronic refractory angina?
Population
65 patients with chronic refractory angina referred to a UK NHS angina centre
Comparison
Temporary sympathectomy by injection of… vs Saline injection (placebo)
Design
RCT, randomised, double-blind
Follow-up
7 days post-injection
Authors
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Bupivacaine stellate ganglion block is not superior to placebo; challenges UK practice and supports placebo-controlled trials of alternatives.
RCT (n=65)
Double-blind
Randomized
No
Does temporary sympathectomy with bupivacaine reduce angina episodes in patients with chronic refractory angina?
p-value: p=0.18
Temporary sympathectomy with bupivacaine did not reduce angina frequency or intensity compared to placebo, suggesting prior reported benefits may be due to placebo or mechanical effects.
Denby et al. (2014) conducted an RCT in Chronic refractory angina (n=65). Temporary sympathectomy (bupivacaine) vs. 15 mL of 0.9% saline was evaluated on Relative percentage change in frequency of angina episodes pre- and post-injection (p=0.18). Temporary sympathectomy with bupivacaine did not significantly reduce the frequency of angina episodes compared to saline placebo (p=0.18), although both groups combined experienced a 31% median reduction.