Summary of findings 1. LASB for pain intensity and duration of pain relief in adults with CRPS.
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Patient or population: adults with CRPS Setting: secondary care Intervention/comparison: LASB vs various comparisons Outcome: pain intensity 0‐10 (VAS or NRS) | ||||
| Comparison | Studies | No of participants (studies) | Result (effect estimates reported where available from study report) | Quality of the evidence (GRADE) |
| LASB vs placebo | Aydemir 2006; Price 1998 | 23 (2) | No significant between‐group difference | ⊕⊕⊕⊝ Moderatea |
| Thoracic LASB + steroid vs subcutaneous local anaesthetic+ steroid | Rocha 2014 | 36 (1) | Favours LASB Mean difference (0‐10 scale) One month −1.25 (95% CI −3.2 to 0.7) One year −2.39 (95% CI −4.72 to −0.06) |
⊕⊝⊝⊝ Very lowb |
| LASB vs ultrasound block | Aydemir 2006 | 18 (1) | No significant between‐group difference | ⊕⊕⊝⊝ Lowc |
| LASB vs IVRB guanethidine | Bonelli 1983 | 19 (1) | No significant between‐group difference | ⊕⊝⊝⊝ Very lowb |
| LASB lumbar plexus vs pulsed radiofrequency lumbar plexus | Freitas 2013 | 40 (1) | No significant between‐group difference | ⊕⊝⊝⊝ Very lowb |
| LASB (lidocaine + clonidine) vs IVRB (lidocaine + clonidine) | Nascimento 2010 | 43 (1) | No significant between‐group difference | ⊕⊝⊝⊝ Very lowb |
| LASB + PT+ pharmacological vs PT + pharmacological | Rodriguez 2005 | 82 (1) | Favours SGB group | ⊕⊝⊝⊝ Very lowb |
| LASB + PT vs PT | Zeng 2003 | 60 (1) | No significant between‐group difference | ⊕⊝⊝⊝ Very lowb |
| Continuous LASB vs continuous brachial plexus block | Toshniwal 2012 | 33 (1) | Favours brachial plexus block | ⊕⊕⊝⊝ Lowc |
| Image‐guided LASB vs nonimage‐guided LASB | Yoo 2012 | 42 (1) | Mean difference 2 weeks postinjection −0.58 (95% CI −1.51 to 0.35) 4 weeks postinjection −0.74 (95% CI −1.36 to −0.12) |
⊝⊝⊝⊝ Very lowd |
| Outcome: hand pain 0‐3 scale | ||||
| LASB vs oral corticosteroids | Lim 2007 | 38 (1) | 15 day follow‐up, no significant between‐group difference at 30 day follow‐up 0.4 (95% CI −0.69 to −0.11), favours LASB with steroid |
⊝⊝⊝⊝ Very lowd |
| Outcome: duration of pain relief | ||||
| LASB bupivacaine + BTA vs LASB bupivacaine | Carroll 2009 | 9 (1) | Increased duration of relief with BTA Median time to analgesic failure (days): LASB bupivacaine + BTA 71 (95% CI 12 to 253) LASB bupivacaine 10 (95%CI 0 to 12) |
⊕⊕⊝⊝ Lowc |
a Downgraded once for imprecision. b Downgraded three times for limitations, inconsistency, and imprecision. cDowngraded twice for inconsistency and imprecision. dDowngraded four times for limitations, inconsistency, indirectness, and imprecision.