Successful treatment of digital ulcers in a scleroderma patient with continuous bilateral thoracic sympathetic block.

摘要: BACKGROUND Raynaud's phenomenon (RP) associated with connective tissue disease (secondary RP) may be difficult to manage conservative therapy. A combination of sympathetically mediated vasospasm and vaso-occlusion has been implicated as the etiology digital ischemic phenomenon. Thoracic sympathetic outflow blocking performed various techniques. However, there have some limitations in all treatment options. OBJECTIVE We report on a patient medically refractory ulceration gangrene caused by scleroderma who was successfully treated continuous infusion mepivacaine into thoracic ganglions means improve finger circulation. CASE REPORT are reporting 32-year-old female suffering from intractable gangrenous ulcer right third left second fingers, accompanied aching pain (VAS, visual analogue scale, 5 - 6/10) numbness both forearms. She underwent through catheter placed T2 vertebral segment for 13 days 11 cervical epidural mepivcaine fentanyl 10 after medical failed. Her temperature increased 2 degrees C during block mepivacine. wounds healed completely without any complications. CONCLUSIONS Continuous ganglionic space led healing fingers scleroderma.