Pete -

I agree that the data is sparce, but there is evidence that patients starting blocks within a few weeks of the onset of CRPS had significant relief lasting two weeks after the last injection, while the farther out treatment was, the less effective it would be. "Efficacy of Stellate Ganglion Blockade for the Management of Type 1 Complex Regional Pain Syndrome," Ackerman WE, Zhang JM, South Med J. 2006; 99:1 084-1088 at 1087, free full text at http://www.rsds.org/2/library/articl...lion_block.pdf

Patients who had early SGB treatment following
the onset of their symptoms had significantly better
pain relief following SGB therapy (r = 0.9).

Now, while I understand and appreciate Karen's point about blocks not working once the pain is SIP, I suspect that something deeper is going on, where the pattern of response as a funtion of the interval between the development of symptoms and initial treatment in the SGB study almost exactly maps with the results of studies strongly suggesting that low dose ketamine can have lasting effects, if and only if initiated within a few weeks of the advent of symptoms. For a good comparision of the results of several low-dose ketamine studies, see the "Discussion" section of "A Pilot Open-Label Study of the Efficacy of Subanesthetic Isometric S(+)-Ketamine in Refractory CRPS Patients," Kiefer RT, Rohr P, Ploppa A, et al, Pain Med. 2008; 9(1):44-54, 50- 53, free full text at http://www.rsds.org/2/library/articl...ohr_Ploppa.pdf. And for anyone who doubts the proposition that ketamine administered early enough can in fact be a "cure," read one of the greatest studies ever published, "Subanesthetic Ketamine Infusion Therapy: A Retrospective Analysis of a Novel Therapeutic Approach to Complex Regional Pain Syndrome," Correll GE, Maleki J, Gracely EJ, Muir JJ, Harbut RE, Pain Med. 2004; 5:263-275, free full text at http://www.rsds.org/2/library/articl...V_Ketamine.pdf.

Something significant is clearly going on here.

Makes one wish that we all had have the level of care that I understand is available in Germany, where local anesthetic is pumped for some time into the affected area, immediately upon the advent of symptoms.

Mike

Mike
You are, as always correct.
See they didn't do this to me, until at least 7 years after the accident that initiated the RSD.
So, I forgot to add that into the "diagram" of treatment....
Yet, the blocks for my lower extremities, were on time, and did the same nothing.
It's all for one!
Each of us reacts differently.
I suppose
that
the best I mean to say is,
If it doesn't work for you,
don't keep going back, and back, and back!

You'll know after a try or two. I think?

That's all......

Pete
Asb

Thanks Mike!

This has been posted many times before, but for a great article, written for laymen, on the use of continuous regional anesthesia on the battlefield in Iraq, and the amazing results they have had with it, check out Silberman S. The Painful Truth. Wired Magazine. 2005 February;13(02). Available at http://www.wired.com/wired/archive/13.02/pain.html?pg=6.

And note to Karen: I just amended my last post (after Pete had captured it for his reply) to address the point on SIP that you had made earlier.