Study: NCT02737527

Intervention type: PROCEDURE
Group type: ACTIVE_COMPARATOR
Intervention: 24G intravenous route for Lumbar Sympathetic Block (LSB):
Description: Enrolled subjects enter the operative room with a 24G intravenous route, and then non-invasive blood pressure and pulse oxygen saturation level are continuously monitored during and after the procedure.

Intervention type: PROCEDURE
Group type: EXPERIMENTAL
Intervention: 24G intravenous route for Lumbar Sympathetic Block (LSB):
Description: Enrolled subjects enter the operative room with a 24G intravenous route, and then non-invasive blood pressure and pulse oxygen saturation level are continuously monitored during and after the procedure.

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: 15-cm Chiba needle for Lumbar Sympathetic Block (LSB)
Description: The skin entry point is infiltrated using 1% lidocaine. A curved 21 G, 15-cm Chiba needle (Cook Inc., Bloomington, IN, USA) is then advanced toward the anterolateral edge of target vertebral body by posterolateral approach in patients with prone position.

Intervention type: DEVICE
Group type: EXPERIMENTAL
Intervention: 15-cm Chiba needle for Lumbar Sympathetic Block (LSB)
Description: The skin entry point is infiltrated using 1% lidocaine. A curved 21 G, 15-cm Chiba needle (Cook Inc., Bloomington, IN, USA) is then advanced toward the anterolateral edge of target vertebral body by posterolateral approach in patients with prone position.

Intervention type: DEVICE
Group type: EXPERIMENTAL
Intervention: Ultrasound for Lumbar Sympathetic Block (LSB)
Description: Using Ultrasound, the L3 is identified by locating the lumbosacral junction on a paramedian sagittal scan and then counting cranially. After marking the level of L3 vertebra, the modified transverse scan through lumbar intertransverse space (ITS) is obtained with the transducer positioned 4-6 cm lateral to the mid-line at the L2-L3 intervertebral level. The needle is inserted from a lateral to medial direction using in-plane technique. The needle tip is inserted towards the anterior fascia of the psoas major muscle as close as paravertebral space.

Intervention type: DEVICE
Group type: ACTIVE_COMPARATOR
Intervention: Fluoroscope for Lumbar Sympathetic Block (LSB)
Description: Briefly, fluoroscopic guided LSBs are performed at the lower third of the L2 or the upper third of the L3 vertebra. A targeted lumbar vertebral is identified by AP fluoroscopic imaging and the fluoroscopic C-arm is adjusted 25-35° laterally to avoid the transverse process over the needle pathway. After the skin infiltration, the needle is advanced toward the anterolateral edge of the target lumbar vertebra under fluoroscopic guidance using the tunnel vision technique.

Intervention type: DRUG
Group type: ACTIVE_COMPARATOR
Intervention: 10 ml of 0.25% levobupivacaine injection for LSB
Description: After excluding vascular injection with contrast media by a C-arm image intensifier on anteroposterior (AP) and lateral view, 10 ml of 0.25% levobupivacaine is injected through the Chiba needle.

Intervention type: DRUG
Group type: EXPERIMENTAL
Intervention: 10 ml of 0.25% levobupivacaine injection for LSB
Description: After excluding vascular injection with contrast media by a C-arm image intensifier on anteroposterior (AP) and lateral view, 10 ml of 0.25% levobupivacaine is injected through the Chiba needle.

Intervention type: PROCEDURE
Group type: ACTIVE_COMPARATOR
Intervention: Temperature measurement for Lumbar Sympathetic Block (LSB)
Description: Temperature monitoring and measurement: skin-surface temperatures are monitored with small, adhesive thermocouple probes attached bilaterally to the plantar surface of the feet using transparent patches at 1-min intervals for a maximum of 20 min.