Key result
Pulse transit time rate of change 5 minutes after lumbar sympathetic ganglion block was higher in successful versus failed blocks (6.46% vs 2.77%), serving as an early indicator of success.
Why the study?
Does the change in pulse transit time at 5 minutes indicate successful lumbar sympathetic ganglion block in patients with lower extremity neuropathic pain?
Observational (n=16)
Does the change in pulse transit time at 5 minutes indicate successful lumbar sympathetic ganglion block in patients with lower extremity neuropathic pain?
Absolute Event Rate: 6.46% vs 2.77%
Pulse transit time measurement 5 minutes after local anesthetic injection is an early, objective indicator of successful lumbar sympathetic ganglion block.
May support early objective assessment of block success in neuropathic pain; leaves open need for prospective validation before clinical use.
Objective To investigate the change in pulse transit time (PTT)-time between the electrocardiographic R wave and the highest point of the corresponding plethysmographic wave-after lumbar sympathetic ganglion block (LSGB) and evaluate PTT as an indicator of successful LSGB. Methods Sixteen cases of sympathetically mediated lower extremity neuropathic pain treated with LSGB were studied. Correlations between the changes in PTT and temperature were used to identify the cutoff point indicating successful LSGB. Results PTT rate of change at 5 min relative to the baseline PTT (dPTT5/PTT0) significantly correlated positively with the temperature change at 20 min (correlation coefficient 0.734). The dPTT5/PTT0 ratios of the Success and Failure groups were 6.46 ± 2.81% and 2.77 ± 1.72%, respectively. The dPTT5/PTT0 cutoff indicating successful LSGB, based on receiver operating characteristic curve analysis, was 4.23%. Conclusion PTT measurement 5 min after local anesthetic injection was an early, objective indicator of successful or failed LSGB.
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Joo et al. (2017) conducted an observational in sympathetically mediated lower extremity neuropathic pain (n=16). Pulse transit time (PTT) measurement vs. Failed lumbar sympathetic ganglion block was evaluated on PTT rate of change at 5 min relative to baseline (dPTT5/PTT0). Pulse transit time rate of change 5 minutes after lumbar sympathetic ganglion block was higher in successful versus failed blocks (6.46% vs 2.77%), serving as an early indicator of success.
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