Abstract
Intravenous regional sympathetic block (IRSB) under continuous prostaglandin E1 (PGE1) intravenous infusion was effective for refractory ulcerative pain in the toe of a patient with progressive systemic sclerosis (PSS). In a 55-year-old female patient with PSS, after thrombectomy of the right common iliac artery were performed, intense refractory ulcerative pain of the right big toe continued. Lumbar epidural block and lumbar sympathetic ganglion block were performed to decrease the pain and improve hypopurfusion of the right big toe. Due to the side effects of long-term administration of anticoagulant drug and platelet aggregation inhibitor which induce easy bleeding, IRSB under continuous PGE1 intravenous infusion was selected and performed. The pain decreased and the ulcer was reduced successfully. IRSB which decreases the pain and increases peripheral blood flow with continuous PGE1 intravenous infusion which increases blood flow seems effective for refractory ulcerative pain in extremities of a patient with PSS.
