A case of thoracic outlet syndrome treated with repeated thoracic sympathetic nerve block

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  • AJIMA Takaaki
    Department of Anesthesia and Pain Medicine, Dokkyo Medical University
  • HAMAGUCHI Shinsuke
    Department of Anesthesia and Pain Medicine, Dokkyo Medical University
  • SHINOZAKI Mio
    Department of Anesthesia and Pain Medicine, Dokkyo Medical University
  • SATO Yuya
    Department of Anesthesia and Pain Medicine, Dokkyo Medical University
  • SAKAGUCHI Yun
    Department of Anesthesia and Pain Medicine, Dokkyo Medical University
  • TAKEMURA Yu
    Department of Anesthesia and Pain Medicine, Dokkyo Medical University

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Other Title
  • 胸部交感神経節ブロックの反復で良好な経過をみた胸郭出口症候群の1例
  • 症例 胸部交感神経節ブロックの反復で良好な経過をみた胸郭出口症候群の1例
  • ショウレイ キョウブコウカン シンケイセツ ブロック ノ ハンプク デ リョウコウ ナ ケイカ オ ミタ キョウカク デグチ ショウコウグン ノ 1レイ

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<p>A 35-year-old man presented with severe pain, numbness, and a cold sensation on the ulnar side of his fifth finger. Although cervical radiculopathy and cubital tunnel syndrome were initially suspected, thoracic outlet syndrome was diagnosed based on a provocation test and the observation of subclavian artery disruption by magnetic resonance angiography. As his activity was impaired due to oral administration of several analgesics, we reconsidered therapeutic treatment. His pain was alleviated with a stellate ganglion block; therefore, we diagnosed his pain as sympathetically maintained pain and performed a left thoracic sympathetic nerve block (TSB). After TSB, his pain was relieved almost completely, and oral analgesics became unnecessary. The patient's pain increased every 6–12 months, and the TSB has been repeated each time, for a total of 6 times, with good clinical results. We conclude that for sympathetically maintained pain caused by thoracic outlet syndrome, careful repetition of TSB may be useful for pain management.</p>

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