Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis

Background and Aims: Stellate ganglion (SG) interventions for treating upper limb complex regional pain syndrome (CRPS) have been reported in studies. However, more substantial evidence is required to reach a consensus on its analgesic efficacy. To the best of our knowledge, no systematic review dem...

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Main Authors: Gaurav Purohit, Baibhav Bhandari, Ajit Kumar, Praveen Talawar, Shiwam Gupta, Pradeep Atter
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Indian Journal of Anaesthesia
Subjects:
Online Access:http://www.ijaweb.org/article.asp?issn=0019-5049;year=2023;volume=67;issue=8;spage=675;epage=684;aulast=Purohit
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author Gaurav Purohit
Baibhav Bhandari
Ajit Kumar
Praveen Talawar
Shiwam Gupta
Pradeep Atter
author_facet Gaurav Purohit
Baibhav Bhandari
Ajit Kumar
Praveen Talawar
Shiwam Gupta
Pradeep Atter
author_sort Gaurav Purohit
collection DOAJ
description Background and Aims: Stellate ganglion (SG) interventions for treating upper limb complex regional pain syndrome (CRPS) have been reported in studies. However, more substantial evidence is required to reach a consensus on its analgesic efficacy. To the best of our knowledge, no systematic review demonstrating the effectiveness of SG intervention for upper limb CRPS has been reported. Hence, this meta-analysis was done to ascertain the efficacy of SG intervention in managing patients with upper limb CRPS. Methods: A database search of PubMed, Cochrane, Embase, Scopus and Google Scholar was done for articles published between January 2001 and December 2021. Two independent reviewers extracted data from the included studies, and the studies were evaluated for any potential risk of bias, and a meta-analysis was performed. Results: Eight studies were included in the qualitative synthesis, four were randomised controlled trials (RCTs), and the rest were non-RCTs. Six studies were assessed quantitatively. A significant reduction in pain scores post-intervention, up to two weeks, and four to 28 weeks after the procedure was observed, although the included studies exhibited marked heterogeneity. Qualitative analysis of these studies revealed an overall improvement in disability scores and functionality as assessed by an improved range of motion. Most studies reported no complications or only short-term minor complications after the procedure. Conclusion: Stellate ganglion interventions improve pain and disability scores with self-limiting short-term complications and no long-term complications. However, further studies with a large sample size are required to validate this treatment modality.
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spelling doaj.art-fea7a66c64264c598f27cea088eb7c1e2023-10-26T06:30:46ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172023-01-0167867568410.4103/ija.ija_204_23Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysisGaurav PurohitBaibhav BhandariAjit KumarPraveen TalawarShiwam GuptaPradeep AtterBackground and Aims: Stellate ganglion (SG) interventions for treating upper limb complex regional pain syndrome (CRPS) have been reported in studies. However, more substantial evidence is required to reach a consensus on its analgesic efficacy. To the best of our knowledge, no systematic review demonstrating the effectiveness of SG intervention for upper limb CRPS has been reported. Hence, this meta-analysis was done to ascertain the efficacy of SG intervention in managing patients with upper limb CRPS. Methods: A database search of PubMed, Cochrane, Embase, Scopus and Google Scholar was done for articles published between January 2001 and December 2021. Two independent reviewers extracted data from the included studies, and the studies were evaluated for any potential risk of bias, and a meta-analysis was performed. Results: Eight studies were included in the qualitative synthesis, four were randomised controlled trials (RCTs), and the rest were non-RCTs. Six studies were assessed quantitatively. A significant reduction in pain scores post-intervention, up to two weeks, and four to 28 weeks after the procedure was observed, although the included studies exhibited marked heterogeneity. Qualitative analysis of these studies revealed an overall improvement in disability scores and functionality as assessed by an improved range of motion. Most studies reported no complications or only short-term minor complications after the procedure. Conclusion: Stellate ganglion interventions improve pain and disability scores with self-limiting short-term complications and no long-term complications. However, further studies with a large sample size are required to validate this treatment modality.http://www.ijaweb.org/article.asp?issn=0019-5049;year=2023;volume=67;issue=8;spage=675;epage=684;aulast=Purohitchronic paincomplex regional pain syndromeneuropathic painstellate ganglionupper extremity
spellingShingle Gaurav Purohit
Baibhav Bhandari
Ajit Kumar
Praveen Talawar
Shiwam Gupta
Pradeep Atter
Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis
Indian Journal of Anaesthesia
chronic pain
complex regional pain syndrome
neuropathic pain
stellate ganglion
upper extremity
title Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis
title_full Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis
title_fullStr Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis
title_full_unstemmed Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis
title_short Efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb—A systematic review and meta-analysis
title_sort efficacy of stellate ganglion interventions for complex regional pain syndrome in the upper limb a systematic review and meta analysis
topic chronic pain
complex regional pain syndrome
neuropathic pain
stellate ganglion
upper extremity
url http://www.ijaweb.org/article.asp?issn=0019-5049;year=2023;volume=67;issue=8;spage=675;epage=684;aulast=Purohit
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