Effect of the Lumbar Sympathetic Block on Pain in Patients with Symptomatic Peripheral Arterial Disease-Retrospective Analysis

ABSTRACT Objective: To study the effect of lumbar sympathetic block (LSB) with a mixture of local anesthetics and steroids on pain in patients with chronic ischemic lower limb disease. Methods: Retrospectively 23 patients were reviewed with peripheral arterial disease who underwent LSB using a mixture of 8 mg of dexamethasone, 80 mg of 2% lidocaine, and 4 mL of saline at 2 levels, L2 and L4, under the guidance of fluoroscopy. Recordings of the Visual Analog Scale (VAS) scores at 3 days before the blockage, and 1 month and 3 months after treatment were obtained. Results: The study included 20 (87%) male and 3 (13%) female patients. The mean age of the patients was 59.65±13.33 years. The patients’ post-blockage 3rd day, and 1st and 3rd month VAS scores were significantly lower than the baseline VAS scores (p<0.05). The proportion of patients with 50% improvement in the VAS scores at 3rd days, and 1st and 3rd months was 47.8%, 21.7%, and 21.7%, respectively. No complications or side effects were observed. Conclusion: Lumbar sympathetic block with a mixture of local anesthetics and steroids appears to be effective in patients who have non-reconstructable arterial occlusive disease, with reduced pain scores and low complication rates. Keywords: Sympathetic nerve block, claudication, visual analog scale, peripheral arterial disease, pain