CONTINUOUS LUMBAR SYMPATHETIC BLOCK FOR THE TREATMENT OF ACUTE ARTERIAL OCCLUSION AND OTHER VASCULAR DISEASES OF THE LOWER EXTREMITY

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Abstract
The effect of continuous lumbar sympathetic block was studied in 48 patients with various peripheral vascular disorders of the lower extremities. The technic consisted of inserting a spinal catheter into the epidural space through the sacral hiatus and connecting it to a flask containing 1000 cc. of 0.1% procaine soln. The anesthetic reached the communicating rami in the peridural space through gravity. The treatment was maintained for a minimum of 24 hrs. Of the 10 patients in the series suffering from sudden occlusion of a major artery, in 2, sufficient collateral circulation developed to preserve the limb, while in the remaining cases either gangrene occured or the patient died of other causes. 7 cases with chronic arterial vascular diseases were treated with continuous blocks and the results were encouraging in that rest pain was reduced during the period of therapy. 12 of 18 patients in the acute stage of deep thrombophlebitis became clinically well during the procedure or almost immediately after the continuous block was stopped. This method gives better results than those obtainable with other means of producing lumbar sympathetic block.

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