Surgery on the affected upper extremity of patients with a history of complex regional pain syndrome: A retrospective study of 100 patients

Surgery on the extremity affected with complex regional pain syndrome (CRPS ) is generally avoided because of the risk that the symptoms will recur or worsen. Perioperative sympathectomy or stellate ganglion block has previous ly been recommended for CRPS patients requiring surgery of the affected upp er extremity. We evaluated 100 patients with a history of upper extremity C RPS undergoing surgery on the affected extremity. All signs and symptoms of CRPS had resolved before surgery. After completion of the surgical procedu re half of the patients (n = 50) underwent a stellate ganglion block; the o ther half received no intervention. The recurrence rate of CRPS was signifi cantly lower in those patients receiving a postoperative stellate ganglion block(n = 5; 10%) compared with those receiving no intervention (n = 36; 72 %). We conclude that performing a perioperative stellate ganglion block in patients with a history of CRPS can significantly reduce the recurrence rat e of this disease process. Copyright (C) 2000 by the American Society for S urgery of the Hand.