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Evidence summaries

Intravenous Sympathetic Blockade for Pain Relief in Reflex Sympathetic Dystrophy

There is not enough evidence to assess the effectiveness of intravenous sympathetic blockade for reflex sympathetic dystrophy. Level of evidence: "D"

A systematic review 1 including 7 RCTs with a total of 101 subjects was abstracted in DARE. Two small studies (17 patients in total) showed some advantage of intravenous sympathetic regional blockade over control treatments. Neither of these studies involved guanethidine.

Comment: The quality of evidence is downgraded imprecise results (few patients and wide confidence intervals) and by study quality (poorly defined diagnostic criteria, inadequate wash-out periods, incomplete crossover, open administration of treatment, no description of technique and the high proportion of withdrawals with no intention to treat analysis).

    References

    • Jadad AR, Carroll D, Glynn CJ, McQuay HJ. Intravenous regional sympathetic blockade for pain relief in reflex sympathetic dystrophy: a systematic review and a randomized, double-blind crossover study. J Pain Symptom Manage 1995 Jan;10(1):13-20. [PubMed] [DARE]

Primary/Secondary Keywords