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Canadian Journal of Anesthesia 53:258-262 (2006)
© Canadian Anesthesiologists' Society, 2006

Regional Anesthesia and Pain

Bilateral pain relief after unilateral thoracic percutaneous sympathectomy

[Contrôle bilatéral de la douleur après une sympathectomie thoracique percutanée]

Michael Gofeld, MD FIPP and Gil Faclier, MD FRCPC

From the Department of Anesthesia, Sunnybrook & Women’s College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

Address correspondence to: Dr. Michael Gofeld, Department of Anesthesia, Sunnybrook & Women’s College Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5, Canada. Phone: 416-480-4864; Fax: 416-480-6039; E-mail: mgofeld{at}rogers.com

Objectif : Présenter un cas de contrôle bilatéral inattendu de la douleur à la suite d’une sympathectomie thoracique percutanée.

Constatations cliniques : Nous présentons un cas où une douleur ischémique sévère causée par un syndrome paranéoplasique de Raynaud, accompagnée de gangrène distale, a été traitée avec succès par une sympathectomie thoracique percutanée. La sympathectomie unilatérale à radiofréquence en T2, T3 combinée à une injection de phénol de faible volume a produit un contrôle bilatéral inattendu de la douleur.

Conclusion : Nos observations suggèrent une innervation sympathique croisée possible aux niveaux cervical et thoracique. La sympathectomie thoracique percutanée peut traiter la douleur ischémique réfractaire aux membres supérieurs.





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